Rédacteur : Johan Nguyen
Sommaire
Postprostatectomy Incontinence
Incontinence urinaire post-prostatectomie
1. Systematic Reviews and Meta-Analysis
1.1. Generic Acupuncture
1.1.1. Tang 2026
Tang Y, Cai Y, Xu F, Wang X, Ding J, Qiao R, Cheng P, Gao Z. Comparative efficacy and safety of acupuncture and moxibustion in the treatment of postprostatectomy urinary incontinence: a systematic review and network meta-analysis. Medicine (Baltimore). 2026;105(3):e44085. https://doi.org/10.1097/MD.0000000000044085
| Background | To compare the efficacy and safety of different acupuncture and/or moxibustion methods in the treatment of postprostatectomy urinary incontinence using frequency-based network meta-analysis (NMA) method. |
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| Methods | Randomized controlled trials (RCTs) on acupuncture and/or moxibustion for postprostatectomy urinary incontinence published from database inception to September 1, 2024, were identified through computerized searches of PubMed, Embase, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP databases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. NMA was conducted using Stata 16.0 software. |
| Results | A total of 17 RCTs involving 9 methods and 1286 patients were included. The NMA showed that needling-warm moxibustion was the most effective in improving the total effective rate, gentle moxibustion (GM) was the most effective in reducing International Consultation on Incontinence Questionnaire-Short Form, and standard acupuncture was the most effective in improving Incontinence Quality of Life Questionnaire. Electroacupuncture had the highest incidence of adverse events. Considering International Consultation on Incontinence Questionnaire-Short Form and Incontinence Quality of Life Questionnaire, GM may be the most ideal choice. |
| Conclusion | Based on NMA, GM, needling-warm moxibustion, and standard acupuncture were found to have the highest probability of being the best therapies. Due to the limitations of this study, these results should be confirmed by detailed RCTs. |
1.1.2. Chen 2023
Chen H, Liu Y, Wu J, Liang F, Liu Z. Acupuncture for postprostatectomy incontinence: a systematic review. BMJ Support Palliat Care. 2023 Oct;13(e1):e10-e19. https://doi.org/10.1136/bmjspcare-2020-002450
| 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. |
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| 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. |
2. Randomized controlled trials
2.1. Sources
Systematic reviews and guidelines for a listing of randomized control trials included:
- Acudoc2: RCT included in the GERA Database and not cited in other sources.
- Tang Y, Cai Y, Xu F, Wang X, Ding J, Qiao R, Cheng P, Gao Z. Comparative efficacy and safety of acupuncture and moxibustion in the treatment of postprostatectomy urinary incontinence: a systematic review and network meta-analysis. Medicine (Baltimore). 2026;105(3):e44085. https://doi.org/10.1097/MD.0000000000044085
- Chen H, Liu Y, Wu J, Liang F, Liu Z. Acupuncture for postprostatectomy incontinence: a systematic review. BMJ Support Palliat Care. 2023 Oct;13(e1):e10-e19. https://doi.org/10.1136/bmjspcare-2020-002450
2.2. List
| Reference | Control | Sources | |
|---|---|---|---|
| 2025 | Liou KT, Carlsson S, Ajay D, Sandhu JS, Li Y, Li QS, Cheung F, Chong K, Booher A, Han K, Lampson K, Nelson C, Morris MJ, Laudone VP, Mao JJ. Acupuncture for Nocturia in Survivors of Prostate Cancer: The NOCTURNAL Randomized Clinical Trial. JAMA Oncol. 2025 May 29. https://doi.org/10.1001/jamaoncol.2025.1199 | Acudoc2 | |
| Niu J, Wang Y, Wang Y, Shi J, Liang J, Zhao X, Xu T, Guo H, Qiu X. Electroacupuncture in Patients With Early Urinary Incontinence After Radical Prostatectomy: A Randomized Clinical Trial. JAMA Netw Open. 2025 Sep 2;8(9):e2534491. https://doi.org/10.1001/jamanetworkopen.2025.34491 | Acudoc2 | ||
| 2024 | Azevedo C, Ferreira da Mata LR, Cristina de Resende Izidoro L, de Castro Moura C, Bacelar Assis Araújo B, Pereira MG, Machado Chianca TC. Effectiveness of auricular acupuncture and pelvic floor muscle training in the management of urinary incontinence following surgical treatment for prostate cancer: A randomized clinical trial. Eur J Oncol Nurs. 2024 Feb;68:102490. https://doi.org/10.1016/j.ejon.2023.102490 | Tang 2026 | |
| Huang S, Tian W, Zheng D. Clinical Study on Low-Frequency Electrical Pulse Acupoint Stimulation Combined with Pelvic Floor Muscle Exercise in the Treatment of Urinary Incontinence after Radical Prostatectomy. Arch Esp Urol. 2024 Jun;77(5):591-597. https://doi.org/10.56434/j.arch.esp.urol.20247705.80. [retrospective study, not RCT] | Tang 2026 | ||
| 2023 | Chu TT, Gao M, Wang SY, et al. [Clinical observation on electroacupuncture at “four points of sacral region” on moderate to severe stress urinary incontinence after radical prostatectomy]. Chinese Acupunct Moxib. 2023;43:756–61 | Tang 2026 | |
| 2022 | Bernardes MFVG, Mata LRFD, Azevedo C, Izidoro LCR, Oliveira CMC, Chianca TCM. Effectiveness of systemic acupuncture in the control of urinary incontinence following radical prostatectomy: a randomized clinical trial. Rev Esc Enferm USP. 2022 Sep 26;56:e20220135. https://doi.org/10.1590/1980-220x-reeusp-2022-0135en | Acudoc2 | |
| Feng X, Lv J, Li M, Lv T, Wang S. Short-term efficacy and mechanism of electrical pudendal nerve stimulation versus pelvic floor muscle training plus transanal electrical stimulation in treating post-radical prostatectomy urinary incontinence. Urology. 2022;160:168–75. https://doi.org/10.1016/j.urology.2021.04.069 | Tang 2026 | ||
| 2021 | Lu QQ, Wang WH. [Clinical study on mild moxibustion plus pelvic floor muscle training for post-radical prostatectomy urinary incontinence]. Shanghai J Acupunct Moxib. 2021;40:739–43. | Tang 2026 | |
| 2020 | Hu YB. [The outcome and mechanism of electroacupuncture “four sacral points” stimulation for post-prostatectomy incontinence]. Shanghai University of Chinese Medicine; 2020. | Tang 2026 | |
| Lin ED. [Based on functional bladder capacity observation clinical effect of Yiqi Guyuan acupuncture method on urinary incontinence and urinary control after radical prostatectomy]. Nanjing University of Chinese Medicine; 2020. | Tang 2026 | ||
| Song NN. [Effect of Yiqi Guyuan acupuncture on urinary control recovery and quality of life of patients with urinary incontinence after radical prostatectomy]. Nanjing University of Chinese Medicine; 2020. | Tang 2026 | ||
| Yang H, Lv TT, Lv X, et al. [Electroacupuncture stimulation of the pudendal nerve for urinary incontinence after radical prostatectomy]. National J Androl. 2020;26:1119–23 | Tang 2026 | ||
| Zhou PP, Wang Y, Xu SP, et al. [Clinical study on urinary incontinence due to kidney qi insufficiency after radical prostatectomy treated with thermal moxibustion combined with pelvic floor muscle training]. Jiangsu J Tradit Chin Med. 2020;52:68–71. | Tang 2026 | ||
| 2019 | Chen Q. [Observation on the effect of acupoint application combined with moxibustion in patients with urinary incontinence after radical prostatectomy]. Electronic J Clin Med Literature. 2019;6:17+19. | Tang 2026 | |
| Huang XX. [Clinical observation on the effect of Yiqi Guyuan acupuncture method on urinary incontinence after radical prostatectomy]. Nanjing University of Chinese Medicine; 2019. | Tang 2026 | ||
| Huang Y, Zhao G. [Effect of acupuncture and moxibustion combined with pelvic floor muscle rehabilitation training on the incidence rates of postoperative urinary incontinence and erectile dysfunction in patients with benign prostatic hyperplasia]. Chinese J Hum Sex 2019;28:113–6. | Chen 2023 | ||
| Xia HC. [Clinical study of progressive treatment of Yiqi Guyuan acupuncture method on urinary incontinence after radical prostatectomy]. Nanjing University of Chinese Medicine; 2019. | Tang 2026 | ||
| 2017 | He L, Dong B, Ou G, et al. [Clinical observation of acupuncture at baliao cooperated with pelvic muscles exercise in the treatment of 76 cases with urinary incontinence after electro-vaporization of prostate]. China Meical Her 2017;14:4. | Chen 2023 | |
| Li YJ, Yang YY, He X. [Effects of rehabilitation nursing combined with warm acupuncture on urinary control function and quality of life in patients with urinary incontinence after radical prostate cancer surgery]. Guiding J Tradit Chin Med Pharmacy. 2017;23:98–100. | Tang 2026 | ||
| Wusiman A, Wangsupu T, Wufuer Y. [Therapeutic effect of solifenacin succinate combined with acupuncture on urinary incontinence after prostatectomy]. Chinese J Ethnomedicine Ethnopharmacy 2017;26:3. | Chen 2023 | ||
| 2016 | Yang M. [Effect of electroacupuncture treatment combined with pelvic floor muscle training on urinary incontinence after prostatectomy]. Public Med Forum Mag 2016;20:1. | Tang 2026, Chen 2023 | |
| 2013 | Huang X. [Effect of electroacupuncture combined with pelvic floor muscle training on urinary incontinence after prostatectomy]. Jilin Med J 2013;34:2. | Chen 2023 | |
| 2012 | Geng Y. [Effect of Acupuncure for Urger urinary Incontinence after transurethral resection of the prostate]. JETCM 2012;21:1821–2. | Chen 2023 | |
| Yang ML. [Clinical observation and nursing care of warm acupuncture point Baresa in adjuvant treatment of postoperative urinary incontinence after prostate cancer surgery]. J Shandong Med College. 2012;34:203–4. | Tang 2026 | ||
| 2010 | Chen L. [Clinical observation on modified indirect moxibustion to treat prostate cancer patients complicating with urinary incontinence after undergoing operation]. Chin Nurs Res. 2010;24:705–6. | Tang 2026 | |
| 2007 | Chen C, Lv F, Cao G, et al. [Alpha receptor agonist combined with degree acupuncture treatment of urinary incontinence after prostatectomy]. Chin Med Fact Mine 2007;20:1. | Chen 2023 |
