A prospective review of medical acupuncture in the management of idiopathic detrusor overactivity

1. No. 059 A prospective review of medical acupuncture in the management of idiopathic detrusoroveractivity Wilson Ailsa, Jenks Julie, Ockrim Jeremy, Greenwell Tamsin University College London Hospitals, United Kingdom Results 24 patients (7 male:17 female) were enrolled. Their results are listed in the table below. Introduction and Aim Sacral neuromodulation, botulinum toxin and augmentation surgery are inaccessible or prohibitively expensive for many patients with intractable overactive bladder (OAB) symptoms. Acupuncture has been explored as a form of neuromodulation which is inexpensive, safe, easy to learn and potentially readily available. Despite its long tradition of use for analgesia and relaxation its claimed benefits in treating urological conditions, have not been supported by a strong body of evidence in the Western scientific literature. We aimed to determine if medical acupuncture could be effective in patients with OAB symptoms who have urodynamically proven idiopathic detrusoroveractivity (IDO) and are refractory to anticholinergics and bladder training. • Methods • Prospective review of all patients who underwent medical acupuncture with a first appointment in the year 2009. All included patients had urodynamically confirmed detrusoroveractivity. • Treatment was for a standard 6 weeks of weekly 1- hour sessions performed by a single trained practitioner using a standard dry needling technique . Acupointscannulated were • Assessment was undertaken before commencement and 2 weeks after the last treatment, and included frequency volume charts, ICIQ – OAB and EQ-5D for idiopathic detrusor over activity. Subjective assessment was also recorded with patients rating treatment as a success or failure. Statistical analysis used Students t-test with P < 0.05. xx * Mean for each patient taken from 3 day voiding diary Fig 1: Acupoints LI4 (hands), SP9, SP6, KI3 (legs) and LR3 (feet) cannulated. Additional acupoints are cannulated on the back (BL23, BL25, BL34) No adverse effects were reported. Some reported a mild increase in 'irritability' after the first treatment, which settled in all patients. 18 patients were able to cease their anticholinergic medication, and did not require any further treatments for overactive bladder. 56% of patients (n=14) reported subjective “significant benefit”. Conclusions Medical acupuncture is a safe and effective treatment beneficial in refractory IDO, producing significant benefit in 56% of patients, and significantly improving all symptoms measured on the ICIQ-OAB and voided volume. Improvement in symptom score did not however appear to correlate with patient reported outcome (PROM) and did not enhance general health perception. In our experience this benefit unfortunately does not extend to those with sensory urgency without detrusoroveractivity, a difference which remains unexplained. Fig 2: Map of the internal and external Qi (energy) flow of the bladder channels Poster presentation sponsor Acknowledgements