To analyze the effectiveness of combination therapy with electroacupuncture (EA) and pelvic floor muscle training for the treatment of stress urinary incontinence after radical prostatectomy and its superiority over pelvic floor muscle training alone.

Forty-four patients with stress urinary incontinence 6 weeks after radical prostatectomy were randomly divided into experimental group (22 cases) and control group (20 cases). The experimental group was treated with pelvic floor muscle training combined with EA, while the control group received pelvic floor muscle training combined with placebo EA. Bilateral Zhongliao and Huiyang acupoints in the lumbosacral region and abdominal Zhongji, Guanyuan and bilateral Dahe acupoints were selected. The treatment parameters were set as continuous wave with a frequency of 50Hz and a current intensity of 1mA~5mA according to patients’ subjective tolerance. Sacral points and abdominal points were treated for 15 minutes, separately. The sessions were lasted for a total of 6 weeks with three times a week on alternate days. For placebo EA group, the same acupoints were approached by blunt needles, but without penetrating the skin. Patients were evaluated at week 3, 6, 10 and 18 after the initiation of treatment. The primary outcome was the change of urine leakage from baseline during 1h pad test at 6 weeks. The secondary outcomes were the changes of ICIQ-UI-SF score, reduction of mean 24-hour pad number, success rate (over 50% reduction from baseline of 1h pad test result at the end of trial) and adverse events.

The reduction of urine leakage amount during 1h pad test in experimental group were significantly more pronounced than that in control group at week 3, 6, 10 and 18 (P＜0.01). Likewise, the ICIQ-UI-SF score of experimental group also demonstrated dramatically decreased at all follow-up timepoints (P＜0.01). As to the 24h pad use, much less daily pad numbers were reported in the experimental group at 6 and 18 weeks (P＜0.01). The success rate of experimental group 72.73%, which is strikingly higher than that of control group (10%, with P＜0.01). No adverse event was documented during treatment and follow-up in both groups.

The findings of our study suggested that pelvic floor muscle training combined with EA significantly reduced urine leakage symptoms and improve quality of life in patients with stress urinary incontinence after radical prostatectomy.

Combination therapy with EA and pelvic floor muscle training is more superior than traditional pelvic floor muscle training alone in treating stress urinary incontinence after radical prostatectomy. However, further data based on larger sample size and long-term follow-up is still expected.