Acupuncture for postprostatectomy incontinence: a systematic review

Background Postprostatectomy incontinence (PPI) is a clinically significant condition that is caused by surgery of prostate. Study showed that electroacupuncture can reduce urine leakage among women with stress urinary incontinence (SUI), but few was known about its efficacy and safety for men with PPI. This study aims to conduct a systematic review to evaluate efficacy and safety of acupuncture for men with PPI compared with other non-surgical treatment. Methods Seven databases were searched for all randomised controlled trials (RCTs) on acupuncture for men with PPI up to August 2020. Risks of bias of included studies were assessed using RevMan V.5.3. Narrative analysis was conducted. Results Seven studies with 830 men with PPI were included in the review. Studies showed that acupuncture can significantly improve score of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form for men with urgent urinary incontinence (UUI) when compared with medicine (p<0.05). It showed a significant better overall response rate when acupuncture was combined with solifenacin for men with UUI (p<0.05), or with pelvic floor muscle training (PFMT) (p<0.001), or with PFMT and medicine together for men with UUI or SUI (p<0.01), compared with control groups. No adverse event was reported in the studies. However, the quality of evidences was considered low generally. Conclusion The results showed that acupuncture could be beneficial for men with PPI when applied alone or as an adjunction to other conservative therapies and medicines, however, the quality of evidence was considered low and inconclusive in this review. PROSPERO registration number This study has been registered at PROSPERO system with ID No. CRD42019091164.