Electroacupuncture for Postoperative Urinary Retention: A Systematic Review and Meta-Analysis

Area of Science:

• Anesthesiology
• Urology
• Integrative Medicine

Background:

• Postoperative urinary retention (PUR) is a common complication.
• Electroacupuncture (EA) is being explored as a treatment for PUR.
• Evidence from randomized controlled trials (RCTs) needs systematic evaluation.

Purpose of the Study:

• To systematically review and evaluate RCTs on electroacupuncture for treating postoperative urinary retention in women.
• To summarize the efficacy and safety of EA in managing PUR.

Main Methods:

• Systematic review of 13 electronic databases up to April 2018, without language restrictions.
• Inclusion of RCTs specifically on women with PUR; exclusion of other retention types or non-RCTs.
• Data extraction by two independent reviewers, with consensus for disagreements; pooled analysis using standard mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CI).

Main Results:

• Statistically significant improvements observed within a week: enhanced therapeutic effect (OR=4.21), reduced residual urine volume (SMD=-13.24), increased bladder capacity (SMD=0.56), and improved urinary flow rate (SMD=0.91).
• Significant effects also noted over a week: improved therapeutic effect (OR=8.29), decreased residual urine volume (SMD=-1.78), increased bladder capacity (SMD=0.92), improved urinary flow rate (SMD=1.69), and earlier first urination (SMD=-0.92).
• Comparisons were made against physical exercise, medication, or no treatment.

Conclusions:

• Electroacupuncture demonstrates statistically significant efficacy and safety for key outcomes in women with postoperative urinary retention.
• The current evidence level for most outcomes is very low to low.
• There is a need for more large-scale, long-term RCTs with rigorous methodological quality to confirm findings.