Electroacupuncture for Mild-to-Moderate Stress Urinary Incontinence in Women: A Systematic Review

Stress urinary incontinence (SUI) is a prevalent condition in women, characterized by involuntary urine leakage during physical exertion. Electroacupuncture (EA) is an effective therapy for SUI, offering minimal side effects, a low economic burden, and good patient compliance. To our knowledge, no systematic review or meta-analysis has specifically evaluated EA for mild-to-moderate SUI in women.

We systematically searched eight Chinese and English databases for randomized controlled trials (RCTs) published between 2002 and 2025. Methodological quality was assessed using the Cochrane Risk of Bias tool (ROB-2), RevMan 5.3, and GRADEpro GDT (version 3.6). Meta-analysis was conducted where feasible, while a qualitative systematic review approach was adopted for outcomes with limited data.

A total of 652 studies were retrieved, of which 10 met the inclusion criteria. The results indicate that EA may be effective in treating mild-to-moderate SUI in women, but the overall quality of evidence is limited and only two studies were categorized as having a low risk of bias, while the remaining eight were appraised as presenting "some concerns". Key limitations include small sample sizes, regional restriction to China, simplistic statistical methods in some studies, limited accuracy, and insufficient trial protocols.

Based on small-scale Chinese trials, EA appears more effective than sham EA, medication, or pelvic floor muscle training (PFMT) in reducing urine leakage and improving ICIQ-SF scores, with superior long-term effects. However, due to limited, low-quality evidence restricted to Chinese populations, we cannot conclusively demonstrate EA's superiority over PFMT or pharmacotherapy for mild-to-moderate SUI in women.