Editor’s Note: This is the latest column from the Society for Acupuncture Research (www.acupunctureresearch.org. Visit the SAR online columnist page for access to previous articles.
Urinary incontinence (UI) after radical prostatectomy is a common and distressing complication for men with prostate cancer. In the weeks immediately following surgery, many patients experience uncontrollable urine leakage, which significantly affects quality of life and emotional well-being.
Currently, pelvic floor muscle training (PFMT) – exercises that strengthen the muscles supporting the bladder – is the standard approach to recovery, but its efficacy is modest, and the results can be slow and incomplete. Recent research shows that electroacupuncture (EA) may help accelerate recovery when used alongside these standard exercises, with evidence suggesting it may enhance urinary continence recovery through sacral nerve stimulation mechanisms.
Study Overview
This prospective, single-center, single-blinded, randomized clinical trial was conducted at Nanjing Drum Tower Hospital from July 2021 to November 2024. A total of 110 men with localized prostate cancer who underwent robot-assisted RP and developed early UI (defined as use of ≥2 pads per day at 4-6 weeks postoperatively) were randomly assigned to either EA or sham stimulation.
The EA group received stimulation at bilateral Ciliao (BL 32), Zhongliao (BL 33) and Xialiao (BL 34) acupoints using sparse-dense wave EA (2-15 Hz) for 30 minutes per session, three times weekly for six weeks. The sham control group underwent identical procedures using nonpuncturing flat-tip needles at offset points. Both groups also performed standard PFMT as part of their postoperative care.
The researchers then followed all participants for five months to track their recovery and measure outcomes including the number of pads used daily, urine leakage volume, symptom severity, and overall quality of life.
Key Findings
At six weeks, twice as many men in the EA group had achieved urinary continence (43.6% vs 21.8% in the placebo group). Men receiving EA also showed greater reductions in daily urine leakage and required fewer pads. Quality-of-life measures related to urinary symptoms improved more significantly in the EA group.
Over the full five-month follow-up period, men in the EA group achieved continence recovery faster than those in the placebo group, with 76.4% becoming continent by the end compared to 67.3% in the placebo group.
Notably, the treatment appeared to work especially well in men whose surgeons had preserved the nerves controlling the urinary sphincter (the muscle that holds urine). Side effects were minimal and comparable in both groups, with no serious adverse events reported.
Clinical Relevance for Acupuncture Practitioners
These findings provide robust evidence that EA at sacral Baliao acupoints represents a safe and effective adjunct to standard post-prostatectomy care for men with early UI. By targeting sacral nerve roots S2-S4 through EA at BL 32, BL 33 and BL 34, practitioners can significantly accelerate continence recovery during the critical early postoperative period, potentially alleviating the psychological burden and quality-of-life impact of persistent incontinence.
The greater efficacy observed in patients with nerve-sparing techniques suggests EA may optimize functional recovery in men who retain residual urethral sphincter innervation.
Incorporating EA into rehabilitation protocols alongside pelvic floor exercises gives patients a meaningful advantage in regaining continence faster and reducing the emotional burden of persistent leakage during recovery.
Conclusion
This randomized clinical trial demonstrates that EA is an effective and safe approach to accelerating urinary continence recovery in men with early UI following radical prostatectomy, with a safety profile comparable to sham controls. While EA speeds up the recovery process rather than fundamentally changing the overall trajectory, the benefit of regaining continence sooner provides clear clinical and quality-of-life advantages during the challenging early recovery period.
These findings support the integration of EA into standard post-prostatectomy rehabilitation programs, with further multicenter validation required to establish optimal treatment parameters and identify patient populations most likely to benefit.
Reference
- Niu J, Wang Y, Wang Y, et al. Electroacupuncture in patients with early urinary incontinence after radical prostatectomy: a randomized clinical trial. JAMA Network Open, 2025;8(9):e2534491. Free full-text available here.
