Acupuncture as a treatment for nocturnal enuresis

Acupuncture can influence spinal micturition centers and parasympathetic innervation to the urinary tract and is known to modulate brain function via the descending serotonergic system. There are numerous difficulties in evaluating the efficacy of acupuncture in patients with nocturnal enuresis (NE), since the patient group is frequently heterogenous and the intervention is commonly given in association with other modalities. Until recently incomplete reporting of the quality aspects of studies has also limited evaluation of treatment effects. The aim of this study was to systematically evaluate reports from both Western and Eastern medicines in which acupuncture was compared to some other treatment modality in children with nocturnal enuresis. Focusing on Chinese language sources 41 new studies of acupuncture for NE were identified, 13 of which were clinical trials that reported parameters of treatment and defined outcome measures of efficacy. A standardized data extraction form was used to evaluate outcome measures and to scrutinize the quality aspects of studies. All barr one study reported the efficacy rate of acupuncture as part of a TCM package to be higher than alarm therapy, the gold standard of Western medicine intervention for NE. Acupuncture as a monotherapy for the treatment of NE appears to be less effective than acupuncture given as part of a combined Traditional Chinese Medicine approach. Electroacupuncture enhances treatment outcomes. (C) 2010 Published by Elsevier B.V.