Acupuncture treatment for persistent post-prostatectomy urinary incontinence: a case series.

Abstract

Radical prostatectomy is considered to be the best treatment for patients with localized and locally advanced prostate cancer. Unfortunately, post-prostatectomy urinary incontinence (PPUI) is a common complication, with an incidence ranging from 4% to 31%.1 PPUI can adversely affect quality of life and cause emotional and financial distress. For most patients, PPUI improves to near baseline levels within 12 months of surgery. However, only a minority of patients with residual PPUI at 12 months experience sustained improvement. Implantation of an artificial urinary sphincter (AUS) represents the gold standard of treatment, although its widespread adoption is limited due to high costs and a significant risk of requiring surgical revision. Hence, early intervention to facilitate patient recovery within 12 months is desirable. For persistent PPUI patients, especially the elderly, we hope to find a safe and non-invasive treatment option that can improve symptoms. Acupuncture is widely used in the treatment of various types of urinary incontinence due to evidence of its effectiveness, the simple nature of the procedure, and its minimal side effects. Electroacupuncture can reduce urine leakage in women with stress urinary incontinence (SUI),2 but relatively little is known about its efficacy and safety for men with PPUI, in whom the quality of evidence is considered to be low. Herein, we report on the use of acupuncture in five patients with persistent PPUI who received routine clinical care at our center.