Clinical study on the efficacy of electroacupuncture combined with pelvic floor muscle training for female stress urinary incontinence

Background: To evaluate the clinical efficacy and synergistic effects of electroacupuncture (EA) combined with pelvic floor muscle training (PFMT) in the treatment of mild-to-moderate stress urinary incontinence (SUI) in women. Methods: A single-blind (assessor-blinded), 2 × 2 factorial, randomized controlled trial was conducted. A total of 128 SUI patients were allocated to 4 groups: the EA group (sessions every other day, targeting acupoints including Guanyuan [RN4] and Shenshu [BL23]), PFMT group (3 daily sessions), combination group (EA + PFMT), and waitlist group. The intervention lasted for 4 weeks. The primary outcome was the change in 1-hour pad test leakage volume. Secondary outcomes included 72-hour urinary incontinence episodes and International Consultation on Incontinence Questionnaire-Short Form scores. Data were analyzed using intention-to-treat and factorial analysis of variance. Results: The combination group showed the greatest reduction in leakage volume (6.17 g, 95% confidence interval [CI] = 5.89–6.44), significantly outperforming the EA group (4.53 g, 95% CI = 4.26–4.81), PFMT group (2.13 g, 95% CI = 1.85–2.41), and waitlist group (0.38 g, 95% CI = 0.11–0.66; all P < .001). Factorial analysis confirmed significant main effects for EA (mean difference = 5.35 g, 95% CI = 5.15–5.54) and PFMT (mean difference = 4.15 g, 95% CI = 3.95–4.34; both P < .001), but no interaction effect ( P = .686). Secondary outcomes showed consistent improvements in incontinence episodes and International Consultation on Incontinence Questionnaire-Short Form scores. Conclusion: Combined EA and PFMT significantly alleviated SUI symptoms. Although no synergy was observed, the additive therapeutic effect provided clinical benefits, offering a promising nonsurgical alternative for SUI management.