Comparative Efﬁcacy of Acupuncture-Related Techniques for Urinary Retention After a Spinal Cord Injury: A Bayesian Network Meta-Analysis

Frontiers in Neurology, 2022 · DOI: 10.3389/fneur.2021.723424 · Published: February 7, 2022

Spinal Cord Injury Alternative Medicine Neurology

Simple Explanation

Urinary retention is a frequent complication of spinal cord injuries (SCI), impacting patient satisfaction and quality of life. Acupuncture, a part of traditional Chinese medicine, has gained attention for managing urinary retention. Different acupuncture techniques exist, and this study uses a Bayesian network meta-analysis (NMA) to compare their effectiveness in treating urinary retention after SCI using both direct and indirect evidence. The study found that electro-acupuncture combined with moxibustion may be the best acupuncture intervention in patients with urinary retention secondary to an SCI.

Study Duration

Not specified

Participants

1,652 patients

Evidence Level

Systematic Review and Bayesian Network Meta-Analysis

Key Findings

1
Electroacupuncture combined with moxibustion ranks ﬁrst in both CER (Clinical Effective Rate) and RUV (Residual Urine Volume).
2
Compared with conventional therapy, manual acupuncture, electro-acupuncture, moxibustion, and electro-acupuncture combined with moxibustion were associated with signiﬁcantly higher probabilities of Clinical Effective Rate (CER).
3
Compared with conventional therapy, manual acupuncture, electro-acupuncture, moxibustion, and electro-acupuncture combined with moxibustion were associated with signiﬁcantly higher probabilities of reducing Residual Urine Volume (RUV).

Research Summary

This Bayesian NMA of acupuncture-related techniques in treating urinary retention in SCI patients included 26 RCTs and found that EA combined with MOX, EA, MOX, and MA significantly increased treatment effects compared with CT. EA combined with MOX may be the most effective acupuncture technique for urinary retention after SCI, providing a clinical reference for using acupuncture to treat neurogenic urinary retention. The study acknowledges differences in designs among included studies, warranting the need for high-quality, large sample size, multicenter clinical trials to make definitive clinical recommendations.

Practical Implications

Clinical Practice

Electro-acupuncture combined with moxibustion may be considered as a potentially more effective acupuncture technique for urinary retention after SCI.

Future Research

High-quality, large sample size, multicenter clinical trials are needed to confirm these findings and establish definitive clinical recommendations.

Decision Making

The study provides essential information to decision-makers regarding acupuncture treatment for neurogenic urinary retention.

Study Limitations

1
Insufﬁcient evidence due to small sample sizes and limited analysis of CER and RUV data.
2
Lack of adverse event reporting limited safety evaluation of acupuncture.
3
Potential for missed eligible studies despite comprehensive literature search.

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