Electroacupuncture Treatment for Urinary Incontinence (UI) in Women
Condition: Electroacupuncture; Urinary Incontinence; Women; Pelvic Floor Muscle Weakness
MeSH terms: Muscle Weakness; Urinary Incontinence; Enuresis
Study type: Interventional

Summary: 
      The investigators have developed an investigation comparing electroacupuncture with pelvic
      floor exercises in female urinary incontinence (UI). It is a randomized clinical trial with
      71 women with UI and two arms: 37 women received electroacupuncture with pelvic floor
      exercises and another arm with 34 women who only received pelvic floor exercises. The
      investigators evaluated the effectiveness using the International consultation on
      incontinence questionaire-urinary incontinence short form (ICQ-UI SF) Spanish version. The
      investigators also evaluated the safety of electroacupuncture in our sample.
    

Detailed description: 
      The International Continence Society defines urinary incontinence (UI) as the objectively
      demonstrable involuntary loss of urine. It affects women of any age. UI significantly impairs
      patients quality of life, limits their autonomy and reduces their self-esteem. The impairment
      of health-related quality of life due to UI can be even greater than that caused by some
      chronic diseases such as diabetes or high blood pressure.

      It is common for this type of disorder to be significantly associated with depressive
      symptoms and feelings of anxiety, which end up affecting the physical, psychological, social,
      cultural and sexual levels.

      UI is classified into: Stress or Effort UI (the most frequent), urge UI and mixed UI. In
      stress UI, involuntary urine leakage is associated with physical exertion that causes an
      increase in abdominal pressure; it occurs as a result of a failure in the urethral resistance
      mechanisms. In urge UI, the involuntary loss of urine is preceded by a compelling desire to
      urinate; it is due to an increase in urinary bladder contractility. In mixed UI, involuntary
      urine loss is associated with stress and urge incontinence.

      The prevalence of UI varies according to the type of study, the definition and assessment of
      UI and the characteristics of the population studied (mainly age and sex, with the frequency
      increasing with age and in women). Worldwide, figures ranging from 5% to 72% have been
      published; in Spain, the available data range from 15% to 42%, the average prevalence being
      estimated at 40.6%. The therapeutic approach to UI can be pharmacological (anticholinergics,
      alpha-blockers and topical estrogens are the most commonly used agents), urological surgery,
      external devices (such as pessary and urethral occluder), pelvic floor exercises and
      stimulation by electroacupuncture.

      The International Consultation on Urological Diseases recommended pelvic floor muscle
      training as A level evidence treating simple mild and moderate stress urinary incontinence,
      which curative rate varies 30% to 60%, although it is a lifelong treatment. Conservative
      interventions such as pelvic floor muscle training are more likely to be used than drugs or
      surgery while a woman is pregnant or in the postnatal period.

      Pelvic floor exercises for the treatment of urinary incontinence was popularized by Arnold
      Kegel (1948). It has been recommended in the treatment of stress and mixed urinary
      incontinence, but has increasingly become part of the treatment of urge UI. It is based on
      two functions of the pelvic floor muscles: support of the pelvic organs, and a contribution
      to the urethral sphincter closure mechanism.

      From the interpretation of traditional Chinese medicine, the problem of urinary incontinence
      may be due to a deficiency of energy or "Qi". The pelvic floor, bladder and anal sphincter
      need significant energy to function properly. This is why it is thought that acupuncture may
      be a beneficial treatment, as it may increase energy along the urinary tract. UI can be
      included in two syndromes depending on the signs and symptoms presented by the patient.

      Our investigators work compares the effectiveness of electroacupuncture on the point R7
      together with pelvic floor exercises versus pelvic floor exercises alone.
    

Intervention name(s): electroacupuncture group
Intervention type(s): Device
Intervention description(s): compare the effectiveness of electroacupuncture on point B7 plus pelvic floor exercises versus pelvic floor exercises alone in women with urinary incontinence (UI) .
Other intervention name(s): pelvic floor exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: clinical study in which participants are assigned to 2 groups.Group K receive kegel´s exercise and the group A receive kegel´s exercise plus electroacupuncture in a point called R7.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment