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A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms


Electroacupuncture (EA) at Zhongliao (BL33) can improve the symptoms of overactive bladder (OAB), such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups: no intervention group, D-BL33 group (deep needling at BL33), S-BL33 group (shallow needling at BL33), non-acupoint group (needling at the non-acupoint next to BL33), Weizhong (BL40) group, Sanyinjiao (SP6) group, Tongtian (BL7) group, and Hegu (LI4) group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval (ICI) of rats with OAB (P = 0.001, P = 0.005, P = 0.046, respectively, post-treatment vs. post-modeling). Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups (all P < 0.01). Significantly shortened vesical micturition time (VMT) and elevated maximum detrusor pressure (MDP) were also observed in the D-BL33 group (P = 0.017 and P = 0.024, respectively, post-treatment vs. post-modeling). However, no statistically significant differences in the changes of VMT and MDP from post-modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.

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  1. 1.

    Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 2010; 21(1): 5–26

    Article  Google Scholar 

  2. 2.

    Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011; 108(7): 1132–1138

    Article  PubMed  Google Scholar 

  3. 3.

    Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int 2008; 101(11): 1388–1395

    Article  PubMed  Google Scholar 

  4. 4.

    Kannan H, Radican L, Turpin RS, Bolge SC. Burden of illness associated with lower urinary tract symptoms including overactive bladder/urinary incontinence. Urology 2009; 74(1): 34–38

    Article  PubMed  Google Scholar 

  5. 5.

    Sexton CC, Coyne KS, Vats V, Kopp ZS, Irwin DE, Wagner TH. Impact of overactive bladder on work productivity in the United States: results from EpiLUTS. Am J Manag Care 2009; 15(4 Suppl): S98–S107

    PubMed  Google Scholar 

  6. 6.

    Gormley EA, Lightner DJ, Faraday M, Vasavada SP; American Urological Association; Society of Urodynamics, Female Pelvic Medicine. Diagnosis and treatment of overactive bladder (nonneurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015; 193(5): 1572–1580

    Article  PubMed  Google Scholar 

  7. 7.

    Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011; 59(11): 2129–2138

    Article  PubMed  Google Scholar 

  8. 8.

    Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Berg KC, Kan F, Irwin CP. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn 2015; 34(3): 224–230

    Article  PubMed  Google Scholar 

  9. 9.

    Finazzi-Agrò E, Petta F, Sciobica F, Pasqualetti P, Musco S, Bove P. Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo controlled trial. J Urol 2010; 184(5): 2001–2006

    Article  PubMed  Google Scholar 

  10. 10.

    Souto SC, Reis LO, Palma T, Palma P, Denardi F. Prospective and randomized comparison of electrical stimulation of the posterior tibial nerve versus oxybutynin versus their combination for treatment of women with overactive bladder syndrome. World J Urol 2014; 32(1): 179–184

    Article  PubMed  CAS  Google Scholar 

  11. 11.

    Peters KM, Carrico DJ, MacDiarmid SA, Wooldridge LS, Khan AU, McCoy CE, Franco N, Bennett JB. Sustained therapeutic effects of percutaneous tibial nerve stimulation: 24-month results of the STEP study. Neurourol Urodyn 2013; 32(1): 24–29

    Article  PubMed  Google Scholar 

  12. 12.

    Peters KM, Carrico DJ, Wooldridge LS, Miller CJ, MacDiarmid SA. Percutaneous tibial nerve stimulation for the long-term treatment of overactive bladder: 3-year results of the STEP study. J Urol 2013; 189(6): 2194–2201

    Article  PubMed  Google Scholar 

  13. 13.

    Yoong W, Shah P, Dadswell R, Green L. Sustained effectiveness of percutaneous tibial nerve stimulation for overactive bladder syndrome: 2-year follow-up of positive responders. Int Urogynecol J Pelvic Floor Dysfunct 2013; 24(5): 795–799

    Article  CAS  Google Scholar 

  14. 14.

    Peters KM, Shen L, McGuire M. Effect of sacral neuromodulation rate on overactive bladder symptoms: a randomized crossover feasibility study. Low Urin Tract Symptoms 2013; 5(3): 129–133

    Article  PubMed  Google Scholar 

  15. 15.

    Olivera CK, Meriwether K, El-Nashar S, Grimes CL, Chen CC, Orejuela F, Antosh D, Gleason J, Kim-Fine S, Wheeler T, McFadden B, Balk EM, Murphy M; Systematic Review Group for the Society of Gynecological Surgeons. Nonantimuscarinic treatment for overactive bladder: a systematic review. Am J Obstet Gynecol 2016; 215(1): 34–57

    Article  PubMed  CAS  Google Scholar 

  16. 16.

    Engberg S, Cohen S, Sereika SM. The efficacy of acupuncture in treating urge and mixed incontinence in women: a pilot study. J Wound Ostomy Continence Nurs 2009; 36(6): 661–670

    Article  PubMed  Google Scholar 

  17. 17.

    Emmons SL, Otto L. Acupuncture for overactive bladder: a randomized controlled trial. Obstet Gynecol 2005; 106(1): 138–143

    Article  PubMed  Google Scholar 

  18. 18.

    Philp T, Shah PJ, Worth PH. Acupuncture in the treatment of bladder instability. Br J Urol 1988; 61(6): 490–493

    Article  PubMed  CAS  Google Scholar 

  19. 19.

    Bergström K, Carlsson CP, Lindholm C, Widengren R. Improvement of urge- and mixed-type incontinence after acupuncture treatment among elderly women— a pilot study. J Auton Nerv Syst 2000; 79(2-3): 173–180

    Article  PubMed  Google Scholar 

  20. 20.

    Chang PL. Urodynamic studies in acupuncture for women with frequency, urgency and dysuria. J Urol 1988; 140(3): 563–566

    Article  PubMed  CAS  Google Scholar 

  21. 21.

    Kelleher C, Filshie J, Burton G, Khullar V, Cardozo L. Acupuncture and the treatment of irritative bladder symptoms. Acupunct Med 1994; 12(1): 9–12

    Article  Google Scholar 

  22. 22.

    Yuan Z, He C, Yan S, Huang D, Wang H, Tang W. Acupuncture for overactive bladder in female adult: a randomized controlled trial. World J Urol 2015; 33(9): 1303–1308

    Article  PubMed  CAS  Google Scholar 

  23. 23.

    Aydogmus Y, Sunay M, Arslan H, Aydin A, Adiloglu AK, Sahin H. Acupuncture versus solifenacin for treatment of overactive bladder and its correlation with urine nerve growth factor levels: a randomized, placebo-controlled clinical trial. Urol Int 2014; 93(4): 437–443

    Article  PubMed  CAS  Google Scholar 

  24. 24.

    Bosch JLHR, Groen J. Sacral (S3) segmental nerve stimulation as a treatment for urge incontinence in patients with detrusor instability: results of chronic electrical stimulation using an implantable neural prosthesis. J Urol 1995; 154(2 Pt 1): 504–507

    Article  PubMed  CAS  Google Scholar 

  25. 25.

    Kitakoji H, Terasaki T, Honjo H, Odahara Y, Ukimura O, Kojima M, Watanabe H. Effect of acupuncture on the overactive bladder. Jpn J Urol (Nihon Hinyokika Gakkai Zasshi) 1995; 86(10): 1514–1519 (in Japanese)

    CAS  Google Scholar 

  26. 26.

    Honjo H, Kawauchi A, Ukimura O, Soh J, Mizutani Y, Miki T. Treatment of monosymptomatic nocturnal enuresis by acupuncture: a preliminary study. Int J Urol 2002; 9(12): 672–676

    Article  PubMed  Google Scholar 

  27. 27.

    Liu Z, Zhou K, Wang Y, Pan Y. Electroacupuncture improves voiding function in patients with neurogenic urinary retention secondary to cauda equina injury: results from a prospective observational study. Acupunct Med 2011; 29(3): 188–192

    Article  PubMed  Google Scholar 

  28. 28.

    Yu SG, Guo Y. Experimental Acupuncture Science. Shanghai: Shanghai scientific & technical publishers, 2009

    Google Scholar 

  29. 29.

    Mitsui T, Kakizaki H, Matsuura S, Ameda K, Yoshioka M, Koyanagi T. Afferent fibers of the hypogastric nerves are involved in the facilitating effects of chemical bladder irritation in rats. J Neurophysiol 2001; 86(5): 2276–2284

    Article  PubMed  CAS  Google Scholar 

  30. 30.

    Hino K, Honjo H, Nakao M, Kitakoji H. The effects of sacral acupuncture on acetic acid-induced bladder irritation in conscious rats. Urology 2010; 75(3): 730–734

    Article  PubMed  Google Scholar 

  31. 31.

    Su X, Nickles A, Nelson DE. Neuromodulation attenuates bladder hyperactivity in a rat cystitis model. BMC Urol 2013; 13(1): 70

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Zhang X, Igawa Y, Ishizuka O, Nishizawa O, Andersson KE. Effects of resiniferatoxin desensitization of capsaicin-sensitive afferents on detrusor over-activity induced by intravesical capsaicin, acetic acid or ATP in conscious rats. Naunyn Schmiedebergs Arch Pharmacol 2003; 367(5): 473–479

    Article  PubMed  CAS  Google Scholar 

  33. 33.

    Wang H, Tanaka Y, Kawauchi A, Miki T, Kayama Y, Koyama Y. Acupuncture of the sacral vertebrae suppresses bladder activity and bladder activity-related neurons in the brainstem micturition center. Neurosci Res 2012; 72(1): 43–49

    Article  PubMed  CAS  Google Scholar 

  34. 34.

    Sato A, Sato Y, Suzuki A. Mechanism of the reflex inhibition of micturition contractions of the urinary bladder elicited by acupuncture- like stimulation in anesthetized rats. Neurosci Res 1992; 15(3): 189–198

    Article  PubMed  CAS  Google Scholar 

  35. 35.

    Noblett K, Siegel S, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Kan F, Berg KC. Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol Urodyn 2016; 35(2): 246–251

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  36. 36.

    Wood LN, Anger JT. Urinary incontinence in women. BMJ 2014; 349: g4531

    Article  PubMed  CAS  Google Scholar 

  37. 37.

    van Balken MR, Vergunst H, Bemelmans BL. The use of electrical devices for the treatment of bladder dysfunction: a review of methods. J Urol 2004; 172(3): 846–851

    Article  PubMed  Google Scholar 

  38. 38.

    Kurpad R, Kennelly MJ. The evaluation and management of refractory neurogenic overactive bladder. Curr Urol Rep 2014; 15 (10): 444

    Article  PubMed  Google Scholar 

  39. 39.

    Chancellor MB, Chartier-Kastler EJ. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation 2000; 3(1): 16–26

    Article  PubMed  CAS  Google Scholar 

  40. 40.

    Kessler TM, La Framboise D, Trelle S, Fowler CJ, Kiss G, Pannek J, Schurch B, Sievert KD, Engeler DS. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis. Eur Urol 2010; 58(6): 865–874

    Article  PubMed  Google Scholar 

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This study was supported by the National Natural Science Foundation of China (Nos. 81173353 and 81373732).

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Correspondence to Zhishun Liu.

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Yang, L., Wang, Y., Mo, Q. et al. A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms. Front. Med. 11, 129–136 (2017).

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  • overactive bladder
  • electroacupuncture
  • acupuncture points