Efficacy and Safety of Electroacupuncture on Mixed Urinary Incontinence Among Women: a Multi-centre, Randomised Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 460
- Primary Endpoint
- the proportion of participants with at least 50 percent decrease from baseline in the mean 24-hour incontinence episodes.
Study Overview
Brief Summary
The purpose of the study is to assess the efficacy and safety of electroacupuncture on mixed urinary incontinence among women.
Detailed Description
After being informed about the study and potential risk, all patients giving written informed consent form will be undergo a 1-week screening period to determine eligibility for study entry. Eligible patients will be randomly assigned to one of the three groups 1) electroacupuncture group: electroacupuncture will be provided to patients at BL33, BL35 and SP6 for 3 time per week for 8 weeks; 2) sham electroacupuncture group: sham electroacupuncture will be provided to patients at sham acupoints to BL33, BL35 and SP6 for 3 time per week for 8 weeks.The follow-up time for the first two groups are 24 weeks and life style counselling will be provided once when receiving the first acupuncture treatment(contents are the same as the life style counselling group). 3) life style counselling group: life style advice will be provided to patients at enrolment with content on drinking, diet, weight control, lung disease, urinary track infection control, and etc. Patients in this group will be followed up for 20 weeks. Primary and secondary outcome will be measured at 4, 8, 20, 32 weeks, respectively.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Investigator, Outcomes Assessor)
Masking Description
The participants, investigator and outcome assessor will be masked. The care provider will be different from investigator and outcome assessor.
Eligibility Criteria
- Ages
- 35 Years to 75 Years (Adult, Older Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients are female and meet the diagnosis criteria of mixed urinary incontinence;
- •Patients are between age of 35 to 75 years old;
- •Positive in cough stress test;
- •Experience persistent urinary incontinence for at least 3 months, and at least one episode for each of stress and urgent urinary incontinence in 72 hours in baseline screening; and
- •Patients have signed informed consent form and are willing to participate the study voluntarily.
- •Patients will be included if all above 5 items are met.
Exclusion Criteria
- •Patients have simple stress urinary incontinence, simple urgent urinary incontinence, overflowing urinary incontinence and neurogenic bladder, etc.;
- •Patients have uncontrolled urinary tract infection with urinary pain and urge;
- •Patients have urogenital system tumours and/or pelvic organ tumours;
- •Patients have taken drugs for urinary incontinence treatment or drugs possibly affect the function of lower urinary tract, or received non-drug treatment for urinary incontinence (i.e. electrical stimulation, bladder training, pelvic floor muscle training, and etc.) in the past one month;
- •Patients have history of surgeries for urinary incontinence and/or pelvic floor organs, including hysterectomy;
- •Patients have pelvic organ prolapse ≥ II degree;
- •Patients have residual urine ≥ 100ml;
- •Patients have uncontrolled diabetes mellitus and severe hypertension;
- •Patients have diseases affecting lower urinary tract function, e.g. multiple sclerosis, Alzheimer's disease, Parkinson's disease, spinal cord injury, cauda equina injury and multiple system atrophy, etc.;
- •Patients have severe heart, lung, brain, liver, kidney and hematopoietic system diseases, mental disorders and cognitive dysfunction;
- •Patients are constrained or unable to complete movements like walking, going stairs up and down and running, etc.;
- •Patients have poor compliance;
- •Patients are at pregnancy, breastfeeding or postpartum period for less than 12 months;
- •Patients have cardiac pacemaker, metal allergy or strong fear of needle;
- •Patients are participants of other on-going studies; or
- •Patients have received acupuncture in the past 3 months. Patients will be excluded if they meet any of the above criteria.
Arms & Interventions
electroacupuncture
patients will receive electroacupuncture at 3 acupoints (Bladder meridian of foot-taiyang 33 and 35（BL33 and BL35), and Spleen meridian of foot-taiyin 33(SP6)) 3 times/week for 8 weeks(24 times in total), followed with 24-weeks follow up. Disposable acupuncture needles with size of 0.30 × 75 mm will be used at BL 33 and BL 35, and needles with size of 0.30 × 40 mm at SP 6. Standardised electroacupuncture apparatuses will be used, and the stimulation will last for 30 minutes with a continuous wave of 20 Hz, and a current intensity of 2 to 6.5 mA at BL33 and BL 35, and 1 to 3.5 mA at SP6. Life style counselling will be provided to all patients and contents are as same as the life style counselling group.
Intervention: electroacupuncture (Other)
electroacupuncture
patients will receive electroacupuncture at 3 acupoints (Bladder meridian of foot-taiyang 33 and 35（BL33 and BL35), and Spleen meridian of foot-taiyin 33(SP6)) 3 times/week for 8 weeks(24 times in total), followed with 24-weeks follow up. Disposable acupuncture needles with size of 0.30 × 75 mm will be used at BL 33 and BL 35, and needles with size of 0.30 × 40 mm at SP 6. Standardised electroacupuncture apparatuses will be used, and the stimulation will last for 30 minutes with a continuous wave of 20 Hz, and a current intensity of 2 to 6.5 mA at BL33 and BL 35, and 1 to 3.5 mA at SP6. Life style counselling will be provided to all patients and contents are as same as the life style counselling group.
Intervention: life style counselling (Behavioral)
sham electroacupuncture
patient will receive sham electroacupuncture with the same frequency and amount as applied in the electroacupuncture group, as well as the follow-up period. Disposable acupuncture needles with size of 0.30 × 40 mm will be applied and penetrate the skin of patients for 2 to 3mm at sham acupoints to the 3 acupoints mentioned above. The stimulation will only last for 30-second with a very weak currency intensity and a continuous wave of 20 Hz. Life style counselling will be provided to all patients and contents are as same as the life style counselling group.
Intervention: sham electroacupuncture (Other)
sham electroacupuncture
patient will receive sham electroacupuncture with the same frequency and amount as applied in the electroacupuncture group, as well as the follow-up period. Disposable acupuncture needles with size of 0.30 × 40 mm will be applied and penetrate the skin of patients for 2 to 3mm at sham acupoints to the 3 acupoints mentioned above. The stimulation will only last for 30-second with a very weak currency intensity and a continuous wave of 20 Hz. Life style counselling will be provided to all patients and contents are as same as the life style counselling group.
Intervention: life style counselling (Behavioral)
life style counselling group
patients randomised to this group will receive a one-time life style counselling at the enrolment to improve their daily behaviour to expedite the recovery of their mixed urinary incontinence. Then the patients will be followed up for 20 weeks.
Intervention: life style counselling (Behavioral)
Outcomes
Primary Outcomes
the proportion of participants with at least 50 percent decrease from baseline in the mean 24-hour incontinence episodes.
Time Frame: at the 8th week after the last treatment
data will be collected and evaluated by 72-hour incontinence episodes dairy
Secondary Outcomes
- the proportion of participants with at least 50 percent decrease from baseline in the mean 24-hour urgent incontinence episodes(at baseline, 4th, 8th 20th and 32nd week)
- the proportion of participants with at least 50 percent decrease from baseline in the mean 24-hour incontinence episodes(at baseline, 4th, 20th and 32nd week)
- the proportion of participants with at least 50 percent decrease from baseline in the mean 24-hour stress incontinence episodes(at baseline, 4th, 8th, 20th and 32nd week)
- the change from baseline in the amount of urine leakage measured by the 1-hour pad test(at baseline, and the 8th week)
- the change from baseline in the validated Chinese version of International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF) scores(at baseline, 4th, 8th, 20th and 32nd week)
- patients' expectation to treatment(at baseline)
- the change from baseline in the validated Chinese version of the Overactive Bladder Questionnaire-Short Form scores(at baseline 4th, 8th, 20th and 32nd week)
- number of patients with one or more life style change(at the 4th, 8th, 20th and 32nd week)
- incidence rate of any adverse events(this is a case-based data reported by each centre from the start of treatment to the end of follow-up, up to 1 year and 4 months.)
- blinding assessment(in 8th week after any acupuncture treatment)
Investigators
Liu Zhishun
Chief Physician, Dean of Acupuncture Department
Guang'anmen Hospital of China Academy of Chinese Medical Sciences