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Overactive Bladder

A Korean trial compared electroacupuncture with plain needling for overactive bladder after menopause. The primary outcome showed no difference

147 women, three arms, six weeks of treatment, and a negative result reported as a negative result. One secondary outcome moved, and the authors say plainly that it was not corrected for multiple testing.

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In short

In a multicentre randomised controlled parallel trial of 147 postmenopausal Korean women with overactive bladder allocated 1:1:1 to electroacupuncture at 16 Hz, electroacupuncture at 2 Hz or manual acupuncture twice weekly for six weeks at CV3, CV4, GV20 and bilateral KI3 and SP6, the primary outcome — change in daily micturitions from baseline to week six — did not differ significantly between groups (p = 0.160), and of the secondary outcomes only total urinary urgency differed, falling further with 2 Hz electroacupuncture than with manual acupuncture (-9.9 against -4.3, p = 0.012), a result the authors describe as tentative because it was not corrected for multiple testing.

Key takeaways

  • 147 postmenopausal Korean women with overactive bladder were randomised 1:1:1 to 16 Hz electroacupuncture, 2 Hz electroacupuncture or manual acupuncture; 140 completed six weeks.
  • All arms received needling twice weekly for six weeks at CV3, CV4, GV20 and bilateral KI3 and SP6.
  • The primary outcome, change in micturitions per 24 hours at week six, did not differ significantly between groups (p = 0.160).
  • Of the secondary outcomes only total urinary urgency differed, reduced further by 2 Hz electroacupuncture than by manual acupuncture (-9.9 against -4.3, p = 0.012).
  • The authors state that this urgency finding was a secondary outcome without correction for multiple testing and should be treated as tentative.
  • No serious adverse events were reported during the treatment period.
  • At the week 10 follow-up, four weeks after treatment ended, scores were largely unchanged and the groups still did not differ.

This trial asked a narrow question and got a clear answer: adding electrical stimulation to acupuncture needles did not beat plain needling for overactive bladder in postmenopausal women. The reason it is worth reporting is that the authors said so.

What was compared, and what was not

All three arms received acupuncture. The randomisation was between 16 Hz electroacupuncture, 2 Hz electroacupuncture and manual acupuncture, at the same points, on the same schedule. There was no sham arm and no untreated arm, which means the trial cannot say whether acupuncture helped these women at all. It can only say that the three techniques performed alike.

That distinction gets lost quickly once a result like this circulates. A three-arm trial with no control answers the question a practitioner asks — which of these should I do — and not the question a patient asks, which is whether to do any of them.

p = 0.160

primary outcome, change in daily micturitions at six weeks, across 16 Hz electroacupuncture, 2 Hz electroacupuncture and manual acupunctureNoh EJ et al., Acupuncture in Medicine, 2025

The one secondary outcome that moved

Total urinary urgency episodes fell further under 2 Hz electroacupuncture than under manual acupuncture, -9.9 against -4.3, at p = 0.012. Taken alone that looks like a finding. The trial measured daytime and nocturnal micturitions, urgency episodes, urge incontinence episodes, the Overactive Bladder Symptom Score and the King's Health Questionnaire, across three arms — a large number of comparisons, of which one came out below 0.05.

Durability and safety

Participants were reassessed at week 10, four weeks after treatment stopped. Most scores were similar to week six and the groups still did not differ from each other — so whatever improvement occurred did not immediately reverse, though without a control arm it cannot be attributed to the needling. No serious adverse events were reported.

Placed next to the drug evidence, the honest position is that these are not yet comparable. Mirabegron has responder rates and safety thresholds measured in thousands of Korean patients. Acupuncture for this condition has a 147-person trial that was not designed to establish whether it works. Both facts can be stated without either being an argument against the other.

Sources

  1. 1

    Noh EJ, Choi SJ, Kim DI, Nam EY, Lim CY, Park JK, Sung WS

    Effectiveness and safety of electroacupuncture and manual acupuncture in postmenopausal women with overactive bladder: a multicenter, randomized, controlled, parallel clinical trial

    Acupuncture in Medicine 2025;43(6):316-329

    doi:10.1177/09645284251399237 · PMID:41277510

    https://doi.org/10.1177/09645284251399237