Acupuncture therapy of overactive bladder: An umbrella review and meta-analysis

Introduction: Overactive bladder (OAB) is a common lower urinary tract symptom of bladder storage dysfunction. Numerous studies have evaluated the efficacy and safety of acupuncture therapy for overactive bladder, but clinical programs and data were largely inconsistent. Therefore, it is necessary to summarize and analyze the published clinical research data in the field. We aimed to perform an umbrella review of systematic reviews and meta-analyses (SRs/MAs) to evaluate the efficacy and safety of acupuncture therapy.

Methods: We searched PubMed, the Cochrane Library, Embase, and three China databases (CNKI, VIP, and Wanfang Data) from the establishment of each database to 1 February 2024. Evaluation tools used the AMSTAR 2 tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) rating system.

Results: A total of seven SRs/MAs were included. Six reviews were rated as critically low on overall confidence and one review was low on confidence based on the AMSTAR 2 tool. The GRADE evidence quality rating demonstrated that the quality of evidence for one outcome indicator was moderate, five were low, and 28 were critically low. Twenty-three of the 34 outcome indicators exhibited a significant improvement compared to the control group. The present research results supported acupuncture as a complementary therapy for OAB patients, but the evidence should be considered carefully due to the methodological flaws identified.

Conclusion: Our study demonstrated that acupuncture, as traditional Chinese medicine, regulates bladder qi and has a good therapeutic effect in the treatment of OAB.