A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms

Likun Yang, Yang Wang, Qian Mo, Zhishun Liu

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Front. Med. ›› 2017, Vol. 11 ›› Issue (1) : 129-136. DOI: 10.1007/s11684-016-0491-6
RESEARCH ARTICLE
RESEARCH ARTICLE

A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms

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Abstract

Electroacupuncture (EA) at Zhongliao (BL33) can improve the symptoms of overactive bladder (OAB), such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups: no intervention group, D-BL33 group (deep needling at BL33), S-BL33 group (shallow needling at BL33), non-acupoint group (needling at the non-acupoint next to BL33), Weizhong (BL40) group, Sanyinjiao (SP6) group, Tongtian (BL7) group, and Hegu (LI4) group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval (ICI) of rats with OAB (P=0.001, P=0.005, P=0.046, respectively, post-treatment vs. post-modeling). Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups (all P<0.01). Significantly shortened vesical micturition time (VMT) and elevated maximum detrusor pressure (MDP) were also observed in the D-BL33 group (P=0.017 and P=0.024, respectively, post-treatment vs. post-modeling). However, no statistically significant differences in the changes of VMT and MDP from post-modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.

Keywords

overactive bladder / electroacupuncture / acupuncture points

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Likun Yang, Yang Wang, Qian Mo, Zhishun Liu. A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms. Front. Med., 2017, 11(1): 129‒136 https://doi.org/10.1007/s11684-016-0491-6

References

[1]
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21(1): 5–26
CrossRef Pubmed Google scholar
[2]
Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011; 108(7): 1132–1138
CrossRef Pubmed Google scholar
[3]
Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int 2008; 101(11): 1388–1395
CrossRef Pubmed Google scholar
[4]
Kannan H, Radican L, Turpin RS, Bolge SC. Burden of illness associated with lower urinary tract symptoms including overactive bladder/urinary incontinence. Urology 2009; 74(1): 34–38
CrossRef Pubmed Google scholar
[5]
Sexton CC, Coyne KS, Vats V, Kopp ZS, Irwin DE, Wagner TH. Impact of overactive bladder on work productivity in the United States: results from EpiLUTS. Am J Manag Care 2009; 15(4 Suppl): S98–S107
Pubmed
[6]
Gormley EA, Lightner DJ, Faraday M, Vasavada SP; American Urological Association; Society of Urodynamics, Female Pelvic Medicine. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015; 193(5): 1572–1580
CrossRef Pubmed Google scholar
[7]
Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011; 59(11): 2129–2138
CrossRef Pubmed Google scholar
[8]
Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Berg KC, Kan F, Irwin CP. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn 2015; 34(3): 224–230
CrossRef Pubmed Google scholar
[9]
Finazzi-Agrò E, Petta F, Sciobica F, Pasqualetti P, Musco S, Bove P. Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo controlled trial. J Urol 2010; 184(5): 2001–2006
CrossRef Pubmed Google scholar
[10]
Souto SC, Reis LO, Palma T, Palma P, Denardi F. Prospective and randomized comparison of electrical stimulation of the posterior tibial nerve versus oxybutynin versus their combination for treatment of women with overactive bladder syndrome. World J Urol 2014; 32(1): 179–184
CrossRef Pubmed Google scholar
[11]
Peters KM, Carrico DJ, MacDiarmid SA, Wooldridge LS, Khan AU, McCoy CE, Franco N, Bennett JB. Sustained therapeutic effects of percutaneous tibial nerve stimulation: 24-month results of the STEP study. Neurourol Urodyn 2013; 32(1): 24–29
CrossRef Pubmed Google scholar
[12]
Peters KM, Carrico DJ, Wooldridge LS, Miller CJ, MacDiarmid SA. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol 2013; 189(6): 2194–2201
CrossRef Pubmed Google scholar
[13]
Yoong W, Shah P, Dadswell R, Green L. Sustained effectiveness of percutaneous tibial nerve stimulation for overactive bladder syndrome: 2-year follow-up of positive responders. Int Urogynecol J Pelvic Floor Dysfunct 2013; 24(5): 795–799
CrossRef Pubmed Google scholar
[14]
Peters KM, Shen L, McGuire M. Effect of sacral neuromodulation rate on overactive bladder symptoms: a randomized crossover feasibility study. Low Urin Tract Symptoms 2013; 5(3): 129–133
CrossRef Pubmed Google scholar
[15]
Olivera CK, Meriwether K, El-Nashar S, Grimes CL, Chen CC, Orejuela F, Antosh D, Gleason J, Kim-Fine S, Wheeler T, McFadden B, Balk EM, Murphy M; Systematic Review Group for the Society of Gynecological Surgeons. Nonantimuscarinic treatment for overactive bladder: a systematic review. Am J Obstet Gynecol 2016; 215(1): 34–57
CrossRef Pubmed Google scholar
[16]
Engberg S, Cohen S, Sereika SM. The efficacy of acupuncture in treating urge and mixed incontinence in women: a pilot study. J Wound Ostomy Continence Nurs 2009; 36(6): 661–670
CrossRef Pubmed Google scholar
[17]
Emmons SL, Otto L. Acupuncture for overactive bladder: a randomized controlled trial. Obstet Gynecol 2005; 106(1): 138–143
CrossRef Pubmed Google scholar
[18]
Philp T, Shah PJ, Worth PH. Acupuncture in the treatment of bladder instability. Br J Urol 1988; 61(6): 490–493
CrossRef Pubmed Google scholar
[19]
Bergström K, Carlsson CP, Lindholm C, Widengren R. Improvement of urge- and mixed-type incontinence after acupuncture treatment among elderly women— a pilot study. J Auton Nerv Syst 2000; 79(2-3): 173–180
CrossRef Pubmed Google scholar
[20]
Chang PL. Urodynamic studies in acupuncture for women with frequency, urgency and dysuria. J Urol 1988; 140(3): 563–566
Pubmed
[21]
Kelleher C, Filshie J, Burton G, Khullar V, Cardozo L. Acupuncture and the treatment of irritative bladder symptoms. Acupunct Med 1994; 12(1): 9–12
CrossRef Google scholar
[22]
Yuan Z, He C, Yan S, Huang D, Wang H, Tang W. Acupuncture for overactive bladder in female adult: a randomized controlled trial. World J Urol 2015; 33(9): 1303–1308
CrossRef Pubmed Google scholar
[23]
Aydoğmuş Y, Sunay M, Arslan H, Aydın A, Adiloğlu AK, Şahin H. Acupuncture versus solifenacin for treatment of overactive bladder and its correlation with urine nerve growth factor levels: a randomized, placebo-controlled clinical trial. Urol Int 2014; 93(4): 437–443
CrossRef Pubmed Google scholar
[24]
Bosch JLHR, Groen J. Sacral (S3) segmental nerve stimulation as a treatment for urge incontinence in patients with detrusor instability: results of chronic electrical stimulation using an implantable neural prosthesis. J Urol 1995; 154(2 Pt 1): 504–507
Pubmed
[25]
Kitakoji H, Terasaki T, Honjo H, Odahara Y, Ukimura O, Kojima M, Watanabe H. Effect of acupuncture on the overactive bladder. Jpn J Urol (Nihon Hinyokika Gakkai Zasshi) 1995; 86(10): 1514–1519 (in Japanese)
[26]
Honjo H, Kawauchi A, Ukimura O, Soh J, Mizutani Y, Miki T. Treatment of monosymptomatic nocturnal enuresis by acupuncture: a preliminary study. Int J Urol 2002; 9(12): 672–676
CrossRef Pubmed Google scholar
[27]
Liu Z, Zhou K, Wang Y, Pan Y. Electroacupuncture improves voiding function in patients with neurogenic urinary retention secondary to cauda equina injury: results from a prospective observational study. Acupunct Med 2011; 29(3): 188–192
CrossRef Pubmed Google scholar
[28]
Yu SG, Guo Y. Experimental Acupuncture Science. Shanghai: Shanghai scientific & technical publishers, 2009
[29]
Mitsui T, Kakizaki H, Matsuura S, Ameda K, Yoshioka M, Koyanagi T. Afferent fibers of the hypogastric nerves are involved in the facilitating effects of chemical bladder irritation in rats. J Neurophysiol 2001; 86(5): 2276–2284
Pubmed
[30]
Hino K, Honjo H, Nakao M, Kitakoji H. The effects of sacral acupuncture on acetic acid-induced bladder irritation in conscious rats. Urology 2010; 75(3): 730–734
CrossRef Pubmed Google scholar
[31]
Su X, Nickles A, Nelson DE. Neuromodulation attenuates bladder hyperactivity in a rat cystitis model. BMC Urol 2013; 13(1): 70
CrossRef Pubmed Google scholar
[32]
Zhang X, Igawa Y, Ishizuka O, Nishizawa O, Andersson KE. Effects of resiniferatoxin desensitization of capsaicin-sensitive afferents on detrusor over-activity induced by intravesical capsaicin, acetic acid or ATP in conscious rats. Naunyn Schmiedebergs Arch Pharmacol 2003; 367(5): 473–479
CrossRef Pubmed Google scholar
[33]
Wang H, Tanaka Y, Kawauchi A, Miki T, Kayama Y, Koyama Y. Acupuncture of the sacral vertebrae suppresses bladder activity and bladder activity-related neurons in the brainstem micturition center. Neurosci Res 2012; 72(1): 43–49
CrossRef Pubmed Google scholar
[34]
Sato A, Sato Y, Suzuki A. Mechanism of the reflex inhibition of micturition contractions of the urinary bladder elicited by acupuncture-like stimulation in anesthetized rats. Neurosci Res 1992; 15(3): 189–198
CrossRef Pubmed Google scholar
[35]
Noblett K, Siegel S, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Kan F, Berg KC. Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol Urodyn 2016; 35(2): 246–251
CrossRef Pubmed Google scholar
[36]
Wood LN, Anger JT. Urinary incontinence in women. BMJ 2014; 349: g4531
CrossRef Pubmed Google scholar
[37]
van Balken MR, Vergunst H, Bemelmans BL. The use of electrical devices for the treatment of bladder dysfunction: a review of methods. J Urol 2004; 172(3): 846–851
CrossRef Pubmed Google scholar
[38]
Kurpad R, Kennelly MJ. The evaluation and management of refractory neurogenic overactive bladder. Curr Urol Rep 2014; 15(10): 444
CrossRef Pubmed Google scholar
[39]
Chancellor MB, Chartier-Kastler EJ. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation 2000; 3(1): 16–26
CrossRef Google scholar
[40]
Kessler TM, La Framboise D, Trelle S, Fowler CJ, Kiss G, Pannek J, Schurch B, Sievert KD, Engeler DS. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis. Eur Urol 2010; 58(6): 865–874
CrossRef Pubmed Google scholar

Acknowledgements

This study was supported by the National Natural Science Foundation of China (Nos. 81173353 and 81373732).

Compliance with ethics guidelines

Likun Yang, Yang Wang, Qian Mo, and Zhishun Liu declare that they have no conflict of interest. All institutional and national guidelines for the care and use of laboratory animals were followed.

RIGHTS & PERMISSIONS

2016 Higher Education Press and Springer-Verlag Berlin Heidelberg
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