Comparative efficacy and safety of acupuncture and moxibustion in the treatment of postprostatectomy urinary incontinence: A systematic review and network meta-analysis.

If you or someone you love has experienced urinary incontinence after prostate surgery, you may be searching for ways to regain control and improve quality of life. A new scientific review suggests that acupuncture and moxibustion — a traditional therapy that uses gentle heat from burning herbs near the skin — may offer real relief.

Researchers analyzed 17 carefully designed clinical trials involving 1,286 patients to compare nine different acupuncture and moxibustion techniques for post-prostatectomy urinary incontinence. This type of large-scale comparison, called a network meta-analysis, allows scientists to rank treatments against each other even when they haven't been directly compared in a single study.

The results were promising. A technique called "needling-warm moxibustion" — which combines acupuncture needles with warming moxibustion heat — was the most effective at producing an overall positive response. "Gentle moxibustion" (GM) scored best at reducing symptom severity as measured by a standard incontinence questionnaire, and standard acupuncture showed the strongest improvement in quality of life scores. When researchers looked at the full picture — both symptom reduction and quality of life — gentle moxibustion emerged as the most well-rounded option.

Importantly, most of these therapies appeared safe. Electroacupuncture had the highest rate of reported side effects among the methods studied, though the researchers note the overall evidence still has limitations and more detailed clinical trials are needed to confirm these findings.

For men navigating life after prostate surgery, these results offer an encouraging sign that traditional East Asian medicine may provide meaningful support alongside conventional care. Always seek treatment from a licensed, experienced acupuncturist who has training in urology-related conditions and can work collaboratively with your medical team.

This systematic review and frequency-based network meta-analysis (NMA) evaluated 17 RCTs (n = 1,286) comparing nine acupuncture and moxibustion modalities for postprostatectomy urinary incontinence (PPUI), sourced from seven databases through September 2024. Interventions included standard acupuncture, electroacupuncture, gentle moxibustion (GM), needling-warm moxibustion, and five additional methods. Primary outcomes included total effective rate, ICIQ-SF scores, and I-QOL scores. NMA results indicated needling-warm moxibustion ranked highest for total effective rate, GM ranked highest for ICIQ-SF reduction, and standard acupuncture ranked highest for I-QOL improvement. Composite ranking across patient-reported outcome measures positioned GM as the most clinically balanced intervention. Electroacupuncture demonstrated the highest adverse event incidence among included modalities. The authors conclude GM, needling-warm moxibustion, and standard acupuncture hold the highest probability of being optimal therapies for PPUI, while calling for larger, methodologically rigorous RCTs to validate these findings.