Acupuncture and Urinary Tract Infection: An Unconvincing Study
December 1998; Volume 1: 8
Source: Aune A, et al. Acupuncture in the prophylaxis of recurrent lower urinary tract infection in adult women. Scand J Prim Health Care 1998;16: 37-39.
Design and Setting: Three-arm controlled clinical trial comparing an acupuncture treatment group, a sham acupuncture group, and an untreated control group, in a ratio of 2:2:1. The setting was an acupuncture clinic in Bergen, Norway.
Subjects: 67 women with a history of recurrent UTI.
Dose/Route/Duration: Individually tailored acupuncture treatments twice weekly for four weeks.
Outcome measures: Acute lower UTIs during the observation period. Patients were interviewed and received urine cultures monthly for six months.
Results: The number of patients who experienced no UTIs during the observation period was 23/27 in the acupuncture group, 15/26 in the sham acupuncture group, and 5/14 in the untreated group. True acupuncture was significantly better than either sham acupuncture or no treatment in this measure.
The incidence rate of lower UTI was significantly different between the real acupuncture group and the untreated control group but was not significantly different between the real and sham acupuncture group.
Funding: Norwegian Research Board.
Comments: This study suffers from a major flaw. It is noted that "several episodes of acute distal urinary symptoms were noted, in which bacterial culture either was not obtained, or was negative. Of these episodes, 17 occurred in the acupuncture group, 25 in the sham group, and 10 in the control group." This is an alarmingly high number of undocumented symptomatic episodes that confounds any positive results of this study. It is not even noted whether women with these symptoms received antibiotic treatment.
While patients were "asked to seek medical aid" for symptoms and were supplied with pre-addressed dipslides and questionnaires to document episodes that occurred between scheduled visits, this clearly was not done. It is unusual in a study of this sort that patients would not be asked to contact study investigators for evaluation of symptoms under study. Had this been done, perhaps the rate of undocumented episodes would have been acceptable. As it stands, the results of this study should not be used as evidence that acupuncture reduces the incidence of UTI.