Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
HT Au (1), PK Kwok (1), SW Wong (1), YY Chung (1), YK Lee (2), J Ko (2), SW Wong (2), HS So (3)
Affiliation :
(1) Integrated Continence Service, United Christian Hospital, (2) Department of Physiotherapy,
United Christian Hospital, (3) Department of Surgery, United Christian Hospital
Introduction :
Overactive active bladder (OAB) causes frequency and sudden urge to urinate that may be difficult to control. It has a tremendous impact on quality of life. Conservative treatment including bladder training, pelvic floor exercise, life style modification and the use of anticholinergic drugs may be considered to some patients. Electroacupuncture (EA) may potentially improve OAB symptoms as an alternative measure and is generally safe. It is a nerve electrical stimulation form of acupuncture.
Objectives :
To evaluate the effectiveness of EA as an alternative treatment for refractory OAB.
Methodology :
Adult patients diagnosed detrusor overactivity by urodynamic study with poor effect of pharmacological therapy were recruited. Exclusion criteria included patients with pacemaker or implantable defibrillator, bleeding tendency, nerve damage, pregnant or planning for pregnancy, needle phobia, cognitive impairment and uncooperative to treatment. The selected patients were referred to the trained physiotherapy and offered a weekly electroacupuncture treatment for 8 weeks. Four acupuncture points located at sacral periosteum (BL33) and posterior of medical aspect of tibia (SP6) were selected .Each EA lasted for 20 minutes. Patients were arranged to have continence clinic follow up for symptom assessment at post 4th and 8th treatment of EA. The OAB symptoms score were assessed by IPSS, OAB-V8, ICIQ and one-hour pad test. Bladder diary and urodynamic study were also evaluated before and after the program.
Result & Outcome :
From July 2022 to August 2023, 8 patients mean age of 66 (range 44-79) with 6 females and 2 males were recruited. One –hour pad test result showed 50% of significant improvement in reduction of urine leakage. Pressure flow study showed 26% decrease in the frequency detrusor overactivity. The treatment had statistically significant improvement in daytime urinary frequency which prolonged from 78.8 to 157.5 minutes (p= 0.002) and nocturia reduced from 2.1 to 1.4 times per night after treatment. Moreover, episode of urinary incontinence alleviated from 3.2 to 2.8 times per day. However, pre and post treatment scores of OAB-V8 (p=0.707), IPSS total (p=0.082) and quality of life (p= 0.451) remained similar.
