Jaspreet S. Sandhu

Background: Nocturia is multifactorial condition, but most treatments only target urine production or storage in isolation. Acupuncture has been shown to decrease nocturia, but its mechanisms remain unclear. This study explores the preliminary effects of acupuncture on urine production and storage to inform future mechanistic hypotheses. Methods: We conducted a secondary analysis of 3-day frequency volume charts from a clinical trial in which prostate cancer survivors with nocturia were randomized to receive acupuncture or usual care (waitlist control [WLC]). Within-group posttreatment changes and between-group differences were compared by paired and two-sample t-tests in the total sample and in subgroups stratified by the presence of nocturnal polyuria at baseline. Results: In the total sample (N = 35), acupuncture reduced nocturia episodes (−1.1 vs −0.4, P = .016) and increased mean urine volume per nighttime void (+30.3 mL vs −0.6 mL, P = .047) relative to the WLC group. In the subgroup with nocturnal polyuria, acupuncture reduced nocturia episodes (−1.1, P = .0057) and reduced the ratio of nocturnal urine volume to total urine volume (−10.7%, P = .02); nocturia episodes also decreased in the WLC group (−0.4, P = .018), but there was no significant change in the ratio of nocturnal urine volume to total urine volume. Conclusions: Among prostate cancer survivors with nocturia, acupuncture demonstrated joint effects on urine production and storage. Acupuncture also reduced nocturia across different types of underlying urinary dysfunction, including nocturnal polyuria. If confirmed, these preliminary findings could inform a novel treatment approach uniquely suited for the multifactorial etiology of nocturia.

Introduction:After RP, clinical complaints of new onset storage symptoms may be related to anastomotic strictures or as accommodation for stress urinary incontinence; however, a subgroup of men wil...