OBJECTIVE: To observe the effect of acupuncture at "pelvic floor six needles" for mild to moderate female stress urinary incontinence (SUI). METHODS: A total of 60 patients with mild to moderate female SUI were randomly divided into an observation group and a control group, 30 cases each group. The control group received Kegel exercise. The observation group received acupuncture at "pelvic floor six needles" on the basis of the treatment as the control group, bilateral Zhongliao (BL33), Zhibian (BL54), Huiyang (BL35), Shuidao (ST28), Dahe (KI12) and Guanyuan (CV4) were selected, once every other day, 3 times a week, 4 weeks as a course of treatment, a total of 2 courses were required. Before treatment and after 4, 8 weeks of treatment, urine leakage in 1 hour, International Consultation on Incontinence questionnaire short form (ICI-Q-SF) score, and incontinence quality of life questionnaire (I-QOL) score were observed in the two groups, and the clinical efficacy was evaluated. RESULTS: After 8 weeks of treatment, urine leakage in 1 hour and ICI-Q-SF scores in both groups were decreased compared with those before treatment (P<0.05), and urine leakage in 1 hour and ICI-Q-SF score in the observation group were lower than those in the control group (P<0.05). After 4, 8 weeks of treatment, I-QOL scores were increased compared with those before treatment in both groups (P<0.05), and the I-QOL scores in the observation group were higher than those in the control group (P<0.01, P<0.001). The total effective rate of the observation group was 93.3% (28/30), which was higher than 73.3% (22/30) in the control group (P<0.05). CONCLUSION Acupuncture at "pelvic floor six needles" could improve the clinical symptoms and quality of life in patients with mild to moderate female SUI to a certain degree.
Humans ; Female ; Acupuncture Therapy/instrumentation* ; Urinary Incontinence, Stress/physiopathology* ; Middle Aged ; Adult ; Exercise Therapy ; Acupuncture Points ; Pelvic Floor/physiopathology* ; Aged ; Treatment Outcome ; Quality of Life

OBJECTIVES: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes. METHODS: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment. RESULTS: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037). CONCLUSIONS Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Middle Aged ; Biofeedback, Psychology ; Adult ; Exercise Therapy/methods* ; Proprioception ; Electroacupuncture/methods* ; Quality of Life ; Electric Stimulation Therapy/methods* ; Treatment Outcome ; Combined Modality Therapy

The paper introduces professor LU Yonghui's clinical experience in treatment of female stress urinary incontinence. Regarding the pathogenesis of this disease, qi and blood deficiency, and malnutrition of moyuan (sites where the pathogens are hidden, and the membranes outside zangfu organs) are ben (the primary, root cause), while, the dysfunction of qi movement of the triple energizer and dysfunction of bladder in controlling urination are biao (the secondary, symptoms). In treatment, under the guidance of computed tomography, Zhongji (CV 3), the front-mu point of the bladder, is punctured deeply to regulate the functions of zang organ. Qihai (CV 6) and Guanyuan (CV 4) are punctured to tonify the organs and control urine, and back-shu points of the bladder meridian are stimulated to adjust qi movement of the triple energizer. All of the acupoints co-act on nourishing moyuan, activating qi movement of the triple energizer and the bladder to control urination.
Humans ; Female ; Acupuncture Points ; Urinary Bladder/physiopathology* ; Acupuncture Therapy ; Urinary Incontinence, Stress/physiopathology* ; Meridians ; Middle Aged ; Adult

OBJECTIVES: Pelvic floor sensory training is commonly used in clinical practice for the treatment of stress urinary incontinence (SUI); however, there is a lack of comparative studies evaluating pelvic floor sensation between women with SUI and healthy controls. Additionally, normative data for two-point discrimination thresholds in the female pelvic floor region remain scarce. This study aims to compare the results of 4 sensory tests in the pelvic floor region between women with mild SUI and healthy women, in order to provide reference values for two-point discrimination thresholds in this area. METHODS: From April 1 to October 30, 2023, 108 healthy women [(32.5±3.6) years] and 90 women with mild SUI [(32.9±3.3) years] were recruited from the Third Xiangya Hospital, Central South University. Participants underwent 4 sensory tests in the pelvic floor region: Two-dot discrimination, weight perception, shape recognition, and 9-grid localization. The results were compared between the 2 groups. RESULTS: Compared with healthy women, those with mild SUI had lower sensitivity and higher thresholds in 2-dot discrimination tests in the pelvic floor region (all P<0.001). No significant differences were found between groups in weight perception, shape recognition, or grid localization tests (P>0.05). CONCLUSIONS Women with mild stress urinary incontinence have impaired two-point discrimination ability in the pelvic floor region.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Adult ; Sensory Thresholds/physiology*

OBJECTIVETo verify the effect of electroacupuncture (EA) for female stress urinary incontinence (SU).

METHODSForty-two patients were randomly divided into an observation group(20 cases) and a control group (22 cases). EA at Zhongliao (BL 33) and Huiyang (BL 35) was used in the observation group. Sham acupuncture at non meridian points, one can beside Zhongliao (BL 33) and Huiyang (BL 35), was applied, and placebo EA was adopted in the control group. Treatment with needle retained for 30 min a time was given once every other day and three times a week for continuous six weeks in the two groups. Urinary and reproductive simple score (UDI),visual analogue scale (VAS) and the frequency of nocturnal enuresis were observed before treatment, at the second, forth and sixth week of treatment in the two groups, and the efficacy was compared.

RESULTSThe effective rates of the observation group were 80.0% (16/20), 95.0% (19/20) and 95.0% (19/20), which were better than 40.9% (9/22), 31.8% (7/22) and 27.3% (6/22) of the control group at the second, forth and sixth week of treatment. The differences were statistically significant between the two groups (all P < 0.05). After treatment in the observation group, the results of UDI, VAS and frequency of nocturnal enuresis were improved compared with those before treatment (all P < 0.05). Along with treatment, all indices were gradually improved, and the change at the sixth week was the most obvious in observation group. The results of the observation group were better than those of the control group at all times (all P < 0.05).

CONCLUSIONEA achieves obvious effect for female SUI, and effectively improves the lower urinary trace symptoms, the degree of urinary incontinence and the frequency of nocturnal enuresis. The effect becomes increasingly better along with treatment within six weeks.

Acupuncture Points ; Electroacupuncture ; Female ; Humans ; Treatment Outcome ; Urinary Incontinence, Stress ; physiopathology ; therapy ; Urination

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Urinary Incontinence, Stress ; physiopathology ; therapy ; Urination

PURPOSE: The definition of posttransobturator tape procedure (post-TOT) voiding dysfunction (VD) is inconsistent in the literature. In this study, we retrospectively investigated the risk factors for post-TOT VD by applying various definitions in one cohort. MATERIALS AND METHODS: The medical records of 449 patients were evaluated postoperatively. Acute urinary retention requiring catheterization, subjective feeling of voiding difficulty during follow-up, and postoperative postvoid residual (PVR) greater than 100 mL or PVR greater than 50% of voided volume (significant PVR) were adopted for the definition of VD. With these categories, multivariate analysis was performed for risk factors of postoperative VD. RESULTS: Ten patients (2.2%) required catheterization, 47 (10.5%) experienced postoperative voiding difficulty, and 63 (14.7%) showed significant PVR. In the multivariate logistic analysis, independent risk factors for postoperative retention requiring catheterization were previous retention history (p=0.06) and preoperative history of hysterectomy. Risk factors for subjective postoperative voiding difficulty were underactive detrusor (p=0.04) and preoperative obstructive voiding symptoms (p<0.01). Previous urinary retention history (p<0.01)) was an independent risk factor for concomitant postoperative voiding difficulty and significant PVR. Spinal anesthesia (p=0.02) and previous urinary retention history (p=0.02) were independent risk factors for significant postoperative PVR. CONCLUSIONS: With the use of several definitions of VD after the midurethral sling procedure, postoperative peak flow rate and PVR were significantly different between groups. Although there were no independent risk factors consistent with various definitions of VD, preoperative obstructive voiding symptoms and objective parameters suggesting impaired detrusor tend to have predictive power for post-TOT VD.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hysterectomy/adverse effects ; Middle Aged ; Retrospective Studies ; Risk Factors ; Suburethral Slings/*adverse effects ; Urinary Catheterization ; Urinary Incontinence, Stress/physiopathology/*surgery ; Urinary Retention/diagnosis/*etiology/physiopathology ; Urodynamics

PURPOSE: Stress urinary incontinence (SUI) is one of the most common lower urinary tract symptoms in women. We analyzed age-associated changes in urodynamic parameters in women with SUI. MATERIALS AND METHODS: We analyzed the urodynamic study (UDS) results of patients with urodynamically proven SUI between March 2008 and July 2014. In uroflowmetry, maximal flow rate (Qmax), time to Qmax, voided volume, and postvoid residual urine volume (PVR) and filling cystometry data including first, strong desire to void and Valsalva leak point pressure (VLPP) were measured. Also, Qmax and detrusor pressure at Qmax (Pdet@Qmax) of voiding cystometry data were analyzed. RESULTS: The subjects included 776 patients. Among the patients, 151 were withdrawn because of incomplete UDS data or because they met the exclusion criteria. A total of 625 patients enrolled in our study. The mean age of the population was 57.3 years. The mean Qmax, voided volume, voiding time, and PVR were 26.2 mL/s, 292.1 mL, 25.7 s, and 31.7 mL, respectively. Qmax (p=0.001) in uroflowmetry, PVR (p=0.042), first desire to void (p=0.042), Pdet@Qmax (p=0.016), and the bladder contractility index (p=0.046) were significantly different between the age groups. Qmax and Pdet@Qmax were decreased and PVR was increased significantly with age after 60 years. CONCLUSIONS: Older women with SUI also have worsened voiding function with age as the results of urodynamic parameters. Specifically, detrusor contractility decreased with age after 60 years.
Aged ; *Aging ; Female ; Humans ; Middle Aged ; Urinary Bladder/*physiopathology ; Urinary Incontinence, Stress/*physiopathology ; *Urodynamics

OBJECTIVETo compare the difference in the clinical efficacy on mild and moderate female stress urinary incontinence (FSUI) between transcutaneous acupoint electrical stimulation and oral administration of midodrine hydrochloride tablets.

METHODSNinety cases of mild and moderate FSUI were randomized into an observation group and a control group, 45 cases in each one. In the observation group, the transcutaneous acupoint electrical stimulation was applied to Ciliao (BL 32), Shenshu (BL 23), Zigong (EX-CA 1), Guanyuan (CV 4) and Qihai (CV 6), once a day. In the control group, midodrine hydrochloride tablets were prescribed for oral administration, 2. 5 mg per treatment, three times each day. The duration of treatment was 4 weeks. The score of international consultation on incontinence questionnaire-urinary incontinence short form (ICI-Q-SF) and leakage of urine in 1 h urinal pad test were observed before and after treatment in the patients of the two groups, and the efficacy was compared between the two groups.

RESULTSThe score of ICI-Q-SF and leakage of urine in urinal pad test after treatment were all improved apparently as compared with those before treatment in the two groups (all P<0. 01), and the results in the observation group were better than those in the control group (both P<0. 01). The total effective rate was 86. 7% (39/45) in the observation group, which was better than 68. 9% (31/45, P<0. 05) in the control group.

CONCLUSIONThe transcutaneous acupoint electrical stimulation achieves the better efficacy on FSUI as compared with the oral administration of midodrine hydrochloride tablets. This therapy effectively improves the patient's urine control ability and reduces leakage of urine.

Acupuncture Points ; Adult ; Female ; Humans ; Middle Aged ; Transcutaneous Electric Nerve Stimulation ; Treatment Outcome ; Urinary Incontinence, Stress ; physiopathology ; therapy

PURPOSE: Urodynamic studies are commonly performed as part of the preoperative work-up of patients undergoing surgery for stress urinary incontinence (SUI). We aimed to assess the extent to which these urodynamic parameters influence patient selection and postoperative outcomes. MATERIALS AND METHODS: Patients presenting with SUI were randomly assigned to two groups: one undergoing office evaluation only and the other with a preoperative urodynamic work-up. Patients with unfavorable urodynamic parameters (detrusor overactivity [DO] and/or Valsalva leak point pressure [VLPP]<60 cm H2O and/or maximum urethral closure pressure [MUCP]<20 cm H2O) were excluded from the urodynamic testing group. All patients in both groups underwent the transobturator midurethral sling procedure. Evaluation for treatment success (reductions in urogenital distress inventory and incontinence impact questionnaire scoring along with absent positive stress test) was done at 6 months and 1 year postoperatively. RESULTS: A total of 72 patients were evaluated. After 12 patients with any one or more of the abnormal urodynamic parameters were excluded, 30 patients were finally recruited in each of the "urodynamic testing" and "office evaluation only" groups. At both the 6- and the 12-month follow-ups, treatment outcomes (reduction in scores and positive provocative stress test) were significantly better in the urodynamic testing group than in the office evaluation only group (p-values significant for all outcomes). CONCLUSIONS: Our findings showed statistically significantly better treatment outcomes in the urodynamic group (after excluding those with poor prognostic indicators such as DO, low VLPP, and MUCP) than in the office evaluation only group. We recommend exploiting the prognostic value of these urodynamic parameters for patient counseling and treatment decisions.
Adult ; Female ; Humans ; Middle Aged ; Patient Selection ; Preoperative Care/*methods ; Prognosis ; Prospective Studies ; *Suburethral Slings ; Treatment Outcome ; Urinary Incontinence, Stress/diagnosis/physiopathology/*surgery ; Urodynamics/*physiology