Effectiveness of simultaneous electroacupuncture stimulation on the tibial and ilioinguinal-iliohypogastric nerves in the treatment of refractory overactive bladder syndrome in women

Abstract

Objectives: The aim of this study was to observe the clinical effectiveness of simultaneous electroacupuncture stimulation on the tibial nerve (TN) and ilioinguinal-iliohypogastric nerve (IIN/IHN) in the treatment of refractory overactive bladder (OAB) in women.

Materials and methods: A prospective study was conducted involving 94 female patients with a diagnosis of OAB in the Urology Department of our hospital from September 2022 to October 2023. The patients were randomly divided into a TN-IIN/IHN group and a control group, each comprising 47 cases. All patients in both groups had received anticholinergic muscarinic receptor antagonists (tolterodine/solifenacin), β3 receptor agonists, flupentixol/melitracen, and other basic treatment regimens with poor results. The TN-IIN/IHN group received simultaneous electroacupuncture on the TN and IIN/IHN, whereas the control group received pelvic floor muscle biofeedback electrical stimulation. Both groups underwent treatment 3 times a week for a total of 4 weeks. Bladder symptoms (24-hour voiding diary), OAB Symptom Score, OAB-Quality of Life Questionnaire, and anxiety and depression scores were compared and analyzed before treatment, after treatment, and at a 3-month follow-up. Clinical efficacy was also assessed.

Results: Both groups showed significant improvement in voiding frequency, nocturia, urgency, OAB Symptom Score, and average voiding volume after treatment and at follow-up (p < 0.01). The TN-IIN/IHN group showed significantly superior results compared with the control group (p < 0.01). Quality of life scores and anxiety and depression scores significantly decreased (p < 0.01), with the TN-IIN/IHN group scores significantly lower than those of the control group (p < 0.01). The treatment success rate in the TN-IIN/IHN group was 84.78%, whereas that in the control group was 28.89%, showing a statistically significant difference (p < 0.01). No significant adverse reactions occurred in either group during the treatment period.

Conclusions: Simultaneous electroacupuncture on the TN and IIN/IHN is effective in treating refractory OAB in women and has good long-term efficacy. This therapy is safe, convenient, and free of significant adverse reactions, providing a new approach for the clinical treatment of refractory OAB in these patients. It significantly improves bladder symptoms and alleviates anxiety and depression, thereby markedly enhancing the patients' quality of life.

Keywords

Electroacupuncture / Tibial nerve / Ilioinguinal-iliohypogastric nerve / Overactive bladder syndrome

Acknowledgments

None.

Statement of ethics

This study was approved by the Ethics Committee of Shanghai Pudong New Area Gongli Hospital (approval no. 2020-KY-28). All participants provided written informed consent. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest statement

The authors declare no conflict of interest.

Funding source

This study was sponsored by the Shanghai Pudong New Area High-level Discipline Construction Clinical Medicine New Quality Specialty (2024-PWXZ-13), the Top-Level Clinical Discipline Project of Shanghai Pudong (PYWgf2021-06), and the Demonstration Pilot Project of Traditional Chinese Medicine Inheritance and Innovation Development in Pudong New Area: The Construction Plan of the Flagship Department of Chinese and Western Medicine Collaboration (Urology) in Pudong New Area (YC-2023-0405).

Author contributions

TTL, WLF: Writing the initial draft of the article;

JWL, ZJW: Reviewing and revising the article;

JWL, ZJW: Research design and protocol development;

WLF, XS: Clinical data collection and analysis;

JWS, ZWL, JH: Patient recruitment;

TTL, JWS, XJ: Clinical treatment procedures.

Data availability

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

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