Study Selection And Data Extraction
All the search results were downloaded and managed by the EndNote . Two independent reviewers reviewed titles and abstracts of all retrieved articles according to the inclusion and exclusion criteria. Then full texts of articles were retrieved from above mentioned databases where necessary and reviewed carefully by the two reviewers to confirm eligible studies, and any disagreement was resolved by the supervisor .
When studies had multiple publications, the one reporting the latest or complete outcome data was included. Another two researchers extracted data from the original publications, including authors’ name, country, year of publication, study design, sample size, patient’s mean age, treatment type and regimen of experiment and control group, frequency and duration of treatments, follow-up time, outcome measures and results, and adverse events.
Description Of The Intervention
Acupuncture is a branch of traditional Chinese medicine that encompasses many methods, such as body acupuncture, scalp acupuncture, auricular acupuncture, warm needling, fire needling and elongated needling. Acupuncture has been used to treat urinary incontinence since ancient times in China. The HuangdiNeijing says For needling, the reinforcing methods should be used for urinary incontinence and the reducing method for urinary retention.
How Acupuncture Helped My Bladder Problems: Part 1
I recently suffered from a particularly nasty bladder infection, and having been so busy recently Ive not really had the time to recover fully. I decided to book myself in for some acupuncture, so today Im talking about how that helped my bladder problems.
Well, this blog seems to have caused a lot of feedback from our website and I have had numerous emails from ladies suffering the same fate as me!
My bladder infection was, I think, a follow on to my fatigue so I have had to work really hard to get myself back into balance.
As women in the menopause we are all guilty of trying to do too much and pleasing everyone, and thus we often forget about ourselves and our needs and this can then result in us getting more and/or worse menopause symptoms. So, I did say in the catch up with you blog post that I was going to do a months detox and take care of myself better. Did I manage it?
Yes and no! I did my month of really healthy eating and no alcohol and I definitely feel better for it now, but life has a big habit of overtaking us and my work and family life have been even busier than usual so my rest and relaxation has been sporadic to say the least hence, I think, my bladder problem taking so long to get better. So I decided that I needed a bit of help.
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Acupuncture Controls Overactive Bladder
Researchers have discovered that acupuncture is effective for controlling overactive bladder syndrome. The research team, a combination of Whipps Cross University Hospital and University College of London Hospital investigators, document that 79% of patients in the study showed clinically significant improvements. The researchers conclude that acupuncture is an effective treatment modality for patients with overactive bladder syndrome and is well tolerated with no side effects or complications. As a result, the research team notes that acupuncture should be considered as a potential alternative to our current therapeutic regimes for patients with OAB.
Overactive bladder syndrome is a dysfunction of the bladders storage abilities that lead to a sudden urge to urinate. Symptoms include a sudden urge to urinate that is often difficult to control, involuntary loss of urine , frequent urination and waking at night 2 or more times to urinate . Etiology varies and may include dysfunction of the kidneys, bladder nerve signals and muscle activity. Contributing and exacerbating factors of OAB include multiple sclerosis , Parkinsons disease, increased fluid intake, kidney and bladder organic disorders, diabetes, pharmaceutical medications and illicit drugs, urinary infections, enlarged prostate and increased consumption of caffeinated beverages.
Data Analysis And Synthesis
For continuous outcome variables, the mean difference with 95% confidence intervals was used to present treatment effect between treatment groups. For dichotomous variables, risk ratio with 95% CIs was adopted to report difference on treatment effects.
Meta-analysis would be undertaken to synthesize outcome variables using dedicated software-Review Manager 5.4 only if the interventions were homogeneous based on clinical criteria. Whereas, qualitative analysis would be done if high heterogeneity was found among included studies.
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Implications Of The Review For Practice And Research
Firstly, for studies using sham EA as the control group compared with true acupuncture, some types of sham EA have psychological effects that may affect the results. Therefore, objective outcomes are better to show efficacy of acupuncture. Secondly, when acupuncture is compared with drugs, blinding of patients and the expectation effects of acupuncture should be measured appropriately. Thirdly, 1 review found that subjective outcomes offer a valuable complement to objective measures, so combining with subjective and objective assessments could make assessments more complete. Lastly, none of the included RCTs mentioned how long the effect of treatment will last, so the follow-up period should be designed in future research to observe the long-term effect of acupuncture.
What Are The Benefits Of Acupuncture For Urinary Incontinence
Studies suggest that over 80% of individuals with UI do not seek treatment due to the stigma and economic burden. As a result, patients with incontinence are also diagnosed with social isolation, insomnia, and deteriorated mental well-being.
Traditional treatment for urinary incontinence involves behavioral therapies, medications, and surgery. However, theres a high discontinuation rate due to the prescribed drugs financial cost and adverse effects.
Fortunately, theres another safe and effective alternative treatment for UI, and thats acupuncture. Here are just some of the benefits of undergoing acupuncture and how it can increase your quality of life despite an overactive bladder.
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Acupuncture For Incontinence Not Infertility
Research yields mixed results for this traditional Chinese treatment
TUESDAY, June 27, 2017 Acupuncture, a 3,000-year-old healing technique, received mixed reviews in two new studies from China one focusing on incontinence and the other on a cause of female infertility.
But in a separate study, another team of researchers determined that acupuncture did not help women who were infertile because of polycystic ovary syndrome . Women with PCOS have a hormonal imbalance that keeps them from releasing an egg during the menstrual cycle.
Acupuncture is a key element of traditional Chinese medicine. It involves inserting thin needles into the skin to stimulate specific body points. Previous research has found it might benefit constipation, depression and morning sickness, among other problems. And some research has found it helpful to boost fertility when the problem is not due to polycystic ovary syndrome, the researchers said.
The bottom line from the two new studies?
For infertility due to polycystic ovary syndrome, however, Shurtleff said acupuncture has not been found effective. He suggested patients consider other options.
More rigorous research on acupuncture is needed in general, he added.
The researchers concluded that acupuncture wont help infertility in women with polycystic ovary syndrome.
Search Methods For The Identification Of Studies
A search strategy will be designed and conducted according to the Cochrane handbook guidelines.29
We will search the following databases from inception to July 2014:
Table 1 presents the full list of search terms to be used.
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Posterior Tibial Nerve Stimulation
There are many studies about posterior tibial nerve stimulation for treatment symptoms of overactive bladder, has been published recently.
In 2012, a review of 30 studies of percutaneous tibial nerve stimulation demonstrated moderate to marked improvement of bladder symptoms. It reduced the number of urinations per day, episodes of leaking of urine, the number of urinations at night. It also increased the volume of urine. Percutaneous tibial nerve stimulation is a technique that involves insertion of acupuncture needle close to the tibial bone on the leg, which is in fact an acupuncture point Sp 6, innervated by posterior tibial nerve. After the insertion, the nerve is stimulated by an electric current for 30 minutes.
Between 2011 and 2013, in a clinical study conducted by a research team at Whipps Cross University Hospital and University College of London Hospital, acupuncture was proven to be effective and did not show any side effects for controlling overactive bladder syndrome, with the rate of 79% of patients in the study showing clinically significant improvements.
Acupuncture Treatment Of Overactive Bladder
Research has shown acupuncture to be effective at reducing symptoms of overactive bladder.
Acupuncture helps reduce the symptoms of overactive bladder by relaxing the nerves and muscles associated with the bladder. Overactive bladder may be caused from bladder spasm creating the sudden need to urinate or a sudden feeling of urination when the bladder is filling, although it is not totally full. Contraction of the pelvic floor muscles may also be a factor. Acupuncture helps to reset these functions to treat overactive bladder.
Acupuncture offers a holistic approach to health and wellness. Acupuncture seeks to understand the imbalance of the interactions between the organs, muscles, and tissues. Once the imbalance is corrected, the root of the problem is improved and body can work to heal itself.
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Search Methods For Study Identification
Based on the Cochrane handbook guidelines, a search strategy should be planned and used. So there were 23 terms in the search strategy which is presented in the protocol, such as a randomized controlled trial.pt, acupuncture.mp, OAB.tw, etc. Two reviewers independently reviewed the next 9 databases from start to August 15, 2017: MEDLINE, EMBASE, The Cochrane Incontinence Group Trials Register, The Cochrane Central Register of Controlled Trials , China National Knowledge Infrastructure , Wan-Fang Data, Chinese Scientific Journal Database, Chinese Biomedical Literature Database , and Chinese Medical Current Content . Acupuncture Research , the Journal of Clinical Acupuncture and Moxibustion , the Shanghai Journal of Acupuncture and Moxibustion , and Chinese Acupuncture and Moxibustion , which were printed out of the duration of the databases, were manually examined in libraries.
Bladder Problems And Incontinence
Signs of a Bladder Problem
Everyones bladder behaves a little bit differently. But certain signs may mean a bladder problem. Signs of a bladder problem can include:
- Inability to hold urine or leaking urine
- Needing to urinate eight or more times in one day
- Waking up many times at night to urinate
- Sudden and urgent need to urinate
- Pain or burning before, during, or after urinating
- Cloudy or bloody urine
- Passing only small amounts of urine after strong urges to urinate
- Trouble starting or having a weak stream while urinating
- Trouble emptying the bladder
A bladder infection is most often caused by a bacterial infection within the bladder. A bladder infection is a type of urinary tract infection . This refers to an infection anywhere in the urinary tract, such as the bladder, kidneys, ureters, or urethra.
Most cases of bladder infections are acute, meaning they occur suddenly. Other cases may be chronic, meaning they recur over the long term. Early treatment is key to preventing the spread of the infection.
Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened. Urinary incontinence is a common problem that affects many people.
Urinary incontinence is more common among women than men. An estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men.
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Inclusion And Exclusion Criteria
Studies would be included if they were investigating adult female patients diagnosed with MUI: the symptoms should combine both SUI and UUI symptoms randomized controlled trials or quasi-RCTs comparing any type of acupunctures , electroacupuncture , scalp acupuncture, auricular acupuncture, intradermal acupuncture, abdominal acupuncture, dry needle, fire needle or elongated needle) with surgery, sham acupuncture, medicine, any other non-surgical therapies, or no treatment evaluating outcome variables on amount of urine leakage in 1 h, urinary incontinence episodes, micturition frequency, and nocturia episodes in 24 h, severity of urinary urgency, quality of life, and etc. No limit was placed for time of publication and language.
Studies would be excluded if they were patients with pure SUI or pure UUI comparing one type of acupuncture with another type of acupuncture case report or series, cross-sectional studies, self-controlled studies, case-control studies, cohort studies, other observational studies or laboratory experiments reviews, protocols, secondary analysis, conference abstracts or posters not providing outcome data or information.
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Review Of Acupuncture And Female Urology
Department of Urology, State University of New York Downstate Medical School, USA
Case Western Reserve University School of Medicine, USA
Wellman W Cheung
Department of Urology, State University of New York Downstate Medical School, USA
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The Lbl Treatment Spectrum
When it comes to treating bladder leakage, women have a wide range of options, from exercises to devices to surgery. Which choice is best for you? It really depends on your personal preferences, how much time, effort, and money you are willing to spend, and which options best fit your lifestyle.
Many women find success using one or more of these non-surgical treatments. Some women, though, choose to skip these options completely and start with surgery.John L. Washington, MD, FACOG, a board-certified urogynecologist in Burlington, North Carolina, believes this is the right choice for some women. “I think it makes sense for a lot of people,” he says, stating that non-surgical options often require continuous effort and aren’t always completely successful. He adds, “Surgery has about an eighty-five to ninety-five percent success rate and can take a relatively short amount of time, depending on the type of surgery.”
Surgical repair can often help women regardless of whether they live an active, sedentary, or average lifestyle however, a woman who is planning to have more children should carefully discuss her options with her doctor. “If a woman is planning to have children, she should put off the surgery,” says Washington. “If she cannot do that, then I would advise a Caesarian section for delivery.”
Data Collection And Analysis
Selection of studies
Two reviewers will screen the studies at the same time independently. If any disagreement occurs, a decision will be made through discussion or consultation with a third author . Details of the study selection procedure are shown in figure 1. Excluded studies will be listed in a table with reasons.
Process of the systematic review.
Before data extraction, a standard form containing specified outcomes will be created after discussion among all reviewers. Two reviewers will extract data independently using this standard form. When data in included studies have been collected but not reported, reviewers will seek clarification from the author. If the reviewers have different opinions, the issue will be resolved through discussion or consultation with a third author .
Risk of bias assessment
The reviewers will independently assess six domains of bias .29 The studies will then be classified into three levels of bias: low, unclear, and high risk of bias. Differences in opinion will be resolved by discussion or consultation with a third author .
Measures of treatment effect
Analysis will be based on available data of included studies. For dichotomous data, the risk ratio will be calculated with 95% CI. For continuous variables, we will use means and SDs to calculate a mean difference with 95% CI.
Unit of analysis issues
The unit of analysis is the individual participant .
Dealing with missing data
Assessment of heterogeneity
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What Foods And Drinks To Avoid
While you may want to drink less liquid so you dont have to urinate as often, you should still make sure you stay hydrated. More concentrated urine, usually darker in color, can irritate your bladder and cause more frequent urination.
Other foods and drinks can contribute to OAB symptoms, including:
- tomato-based foods
You can test which drinks or foods irritate your bladder by eliminating them from your diet. Then reincorporate them one by one every two to three days at a time. Permanently eliminate the particular food or drink that worsens your symptoms.
Pudendal Nerve Stimulation For Overactive Bladder
Pudendal nerve is the major nerve that is responsible for the transmission of sensations from the perineum to the spinal cord and supplies motor innervation to the muscles of the pelvic floor. It originates from sacral spinal nerves and enters the perineum through the lesser sciatic foramen to supply the perineal muscles and skin.
What is pudendal nerve stimulation?
- The patient lies prone and about 2 points on either side of buttock muscles and 2 additional points on a lower back are selected
- The acupuncture needles are inserted into these areas
- The electrodes are then connected to deliver the appropriate stimulation in terms of frequency, intensity and duration based on the type of the ailment being treated
In a study where 120 females with urinary incontinence were treated with either pudendal nerve or transvaginal electrical stimulation, higher percentage of those that had pudendal nerve stimulation recorded complete symptom resolution with more than 50% of symptom improvement in the rest. The study therefore, concluded that pudendal nerve stimulation is an effective and better treatment modality for urinary incontinence in females.
Sunrise Neuro-Acupuncture Integrative Clinic is an acupuncture and Chinese medicine clinic in Westboro, Ottawa. We provide care for overactive bladder. If you would like to receive more information about this treatment, you can call us at: 613-853-9099
2. Li C et al. Acupuncture in the management of overactive bladder syndrome
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