Is Lumbosacral Electroacupuncture Effective for Stress Urinary Incontinence?

Stress urinary incontinence (SUI) is a common and often under-discussed condition that can greatly impact quality of life. As a pelvic health and women’s health specialist, I’m always interested in research that explores evidence-based, non-invasive approaches to support those experiencing SUI. Two studies—Xu et al. (2016) and Liu et al. (2017)—investigated the effectiveness of lumbosacral electroacupuncture (EA) for the treatment of SUI. Here’s a look at what they found and how it may apply in clinical practice.

Study Overview: Xu et al., 2016

This randomized controlled study assessed the efficacy of electroacupuncture in women with pure stress urinary incontinence. Eighty women participated and were divided into two groups of 40.

• The electroacupuncture group received deep needling at BL33 and BL35.

• The control group received sham EA using non-penetrating needling at sham points 20 mm lateral to BL33 and BL35.
  Both groups received three sessions per week for six weeks, with follow-ups over 24 weeks.

Key Outcomes

The primary outcome was measured through a pad test. Participants performed a series of activities designed to induce leakage—walking, climbing stairs, coughing, running in place, and more—after drinking 500 ml of water. Secondary outcomes included changes in 72-hour incontinence frequency, total ICIQ-SF scores, and patient self-evaluations of therapeutic effect at weeks 6, 18, and 30.

Results

The sham EA group showed no significant change, while the EA group had a notable reduction in urine leakage after six weeks and continued improvements through week 30. Quality of life scores also improved significantly, suggesting both short-term and long-term benefits.

Limitations

The main limitations were the small sample size and the potential for sham acupuncture to have mild therapeutic effects. Additionally, participants had only mild to moderate SUI, and the study did not compare EA to pelvic floor muscle training, which remains the gold standard treatment.

Study Overview: Liu et al., 2017

In this larger randomized controlled study, 502 women were divided equally into a sham acupuncture group and an electroacupuncture group. Both received 18 sessions over six weeks.

• The EA group received deep needling to BL33 and BL35.

• The control group received non-penetrating needling at sham acupoints 20 mm lateral to those points.

Key Outcomes

The primary outcome was again assessed using the 1-hour pad test after participants drank 500 mL of water and performed various physical activities.

By week 6, the EA group showed a 50% or greater reduction in urine leakage compared with the sham group. The EA group also had a greater improvement in ICIQ-SF quality of life scores.

Limitations

This study did not perform the pad test at the 24-week follow-up, limiting insight into long-term efficacy. Blinding was another concern—blinding assessment was only completed in 2 of 12 centers. And, as with many acupuncture studies, sham needling may have had mild therapeutic effects.

Clinical Relevance

Both Xu et al. (2016) and Liu et al. (2017) demonstrate that lumbosacral electroacupuncture at BL33 and BL35 may be effective for stress urinary incontinence, showing improvements in both objective (pad test) and subjective (quality of life) measures.

In my practice, I see many clients with SUI and frequently use electroacupuncture along the tibial nerve, adductor hallucis longus, and sacral bone holes. These studies are particularly relevant because they align with what I observe clinically—EA can have a meaningful impact on leakage reduction and quality of life.

While I’d like to see more research focusing on long-term outcomes, frequency of treatment, and comparisons to pelvic floor muscle training, these studies reinforce that lumbosacral EA has clinical potential.

Clinical Reflections

In my own work, I rarely see clients multiple times per week, so I’m curious about how effective these protocols might be when used less frequently but over a longer duration. I also find that EA to the sacrum and coccyx can be a tender area, and therefore I always approach treatment through a trauma-informed lens to ensure client comfort and safety.

It’s also worth noting that the needle angle at BL35 is important—angling slightly lateral helps avoid the risk of puncturing the colon at deeper depths.

Overall, I found these studies both inspiring and clinically relevant, even with their limitations. They offer valuable insight into how lumbosacral EA may serve as a supportive therapy for stress urinary incontinence.

References

Xu, H., Liu, B., Wu, J., Du, R., Liu, X., Yu, J., & Liu, Z. (2016). A Pilot Randomized Placebo Controlled Trial of Electroacupuncture for Women with Pure Stress Urinary Incontinence. PLOS ONE, 11(3), e0150821. https://doi.org/10.1371/journal.pone.0150821

Liu, Z., Liu, Y., Xu, H., He, L., Chen, Y., Fu, L., Li, N., Lu, Y., Su, T., Sun, J., Wang, J., Yue, Z., Zhang, W., Zhao, J., Zhou, Z., Wu, J., Zhou, K., Ai, Y., Zhou, J., & Pang, R. (2017). Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence. JAMA, 317(24), 2493. https://doi.org/10.1001/jama.2017.7220