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New NICE guidance on urinary incontinence should include acupuncture, says membership body

New NICE guidance on urinary incontinence should include acupuncture, says membership body

The British Acupuncture Council has said it is ‘extremely disappointed’ that updated guidance on the treatment of urinary incontinence does not include acupuncture.

The new guidance, published today by the National Institute for Health and Care Excellence (NICE), recommends mainline treatments including losing weight, eliminating caffeine, pelvic floor exercises, bladder training through behavioural therapy and anticholinergic medicines.

But it fails to include acupuncture as a recommended treatment, despite the publication of two landmark, high quality clinical studies showing positive results.

Head of research at the British Acupuncture Council, Mark Bovey, said: 'At a time when the NHS is under so much pressure, health leaders should be exploring effective alternatives to conventional care.

‘The British Acupuncture Council is extremely disappointed that NICE has failed to include acupuncture as a recommended treatment for urinary incontinence in its guidance, even though we alerted them to the research during the consultation period.

‘Pelvic floor exercises and anticholinergic drugs are mainline recommendations by NICE for urinary incontinence, but compliance can be a problem with the former and adverse effects with the latter. Long term adherence to both can be poor.

‘Acupuncture is very safe and has high levels of patient satisfaction, so it would appear to provide a sensible alternative option for the NHS.'

In January 2019, a large study, carried out by Lui et al at the respected Chinese Academy of Medical Sciences in Beijing, showed that in women with moderate to severe mixed urinary incontinence (MUI), electroacupuncture was not inferior to standard treatment.

The randomised controlled trial (RCT) was carried out across ten hospitals in China between 1 March 2014 and 10 October 2016.

Patients were randomised to receive either electroacupuncture (36 sessions) over 12 weeks with 24 weeks of follow-up, or standard treatment of pelvic floor muscle training (PRMT) with antimuscarinic agent, solifenacin (5mg/d) for 36 weeks.

Of the 500 participants, 467 completed the trial (239 in the electroacupuncture group and 228 in the PFMT-solifenacin group). Between weeks one and 12, there was a 38% reduction from baseline in mean 72-hour urinary incontinence episode frequency (IEF) in the electroacupuncture group and a 36% reduction in the PFMT-solifenacin group.

Another large RCT, conducted by Liu and his team, and published in 2017, showed that electroacupuncture, compared with sham electroacupuncture, resulted in less urine leakage after six weeks. This was for stress urinary incontinence (SUI), one of the three main types along with urgency urinary incontinence (UUI) and MUI. According to research, up to 70% of women will suffer from one or more of these at some point in their life

For UUI there is still a need for large high-quality trials. In the latest systematic review (Zhao 2018), acupuncture was shown to be more effective than sham in decreasing night-time incontinence, relieving voiding symptoms and enhancing patients’ quality of life. Ten RCTs with 794 patients were included.


Notes to editor

For further information, case studies or interviews, please contact: Katie Osborne on 07990 922615 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

About the BAcC

The British Acupuncture Council (BAcC) has a membership of nearly 3,000 professionally qualified acupuncturists. It is the UK's largest professional body for the practice of acupuncture. BAcC members practise a traditional, holistic style of acupuncture diagnosis and treatment based on a system developed and refined over 2,000 years. To achieve BAcC membership, practitioners must first undertake extensive training in traditional acupuncture (minimum three years full-time or part-time equivalent), which includes physiology, anatomy and other biomedical sciences appropriate to the practice of acupuncture.

Traditional acupuncture

Traditional acupuncture as practised by members of the BAcC is based on Chinese medicine principles that have been developed, researched and refined for over 2,500 years. Traditional acupuncture is holistic, not focused on isolated symptoms. It regards pain and illness, whether physical or mental, to be a sign the whole body is out of balance. Western or medical acupuncture is a more recent development practised predominantly by doctors and physiotherapists, who use acupuncture techniques within their existing scope of practice on the basis of a western medical diagnosis. There is a growing body of evidence showing how effective acupuncture is in a range of conditions:

Why use a BAcC practitioner?

Only British Acupuncture Council members belong to a Professional Standards Authority accredited register, providing professional guarantees of safety, education and continuing development (

Look for the letters MBAcC after the name of your acupuncturist to ensure:

  • extensive training – minimum three years degree level – with relevant western medicine including anatomy and physiology
  • adherence to BAcC codes of safe practice and professional conduct
  • compliance with current health and safety legislation
  • full insurance cover for medical malpractice and public/products liability
  • mandatory continuing professional development to keep knowledge and skills up to date
  • postgraduate study of special interests such as pain management and acupuncture for children

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