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

BACKGROUND: To compare the efficacy and safety of different acupuncture and/or moxibustion methods in the treatment of postprostatectomy urinary incontinence using frequency-based network meta-analysis (NMA) method. METHODS: Randomized controlled trials (RCTs) on acupuncture and/or moxibustion for postprostatectomy urinary incontinence published from database inception to September 1, 2024, were identified through computerized searches of PubMed, Embase, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP databases. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. NMA was conducted using Stata 16.0 software. RESULTS: A total of 17 RCTs involving 9 methods and 1286 patients were included. The NMA showed that needling-warm moxibustion was the most effective in improving the total effective rate, gentle moxibustion (GM) was the most effective in reducing International Consultation on Incontinence Questionnaire-Short Form, and standard acupuncture was the most effective in improving Incontinence Quality of Life Questionnaire. Electroacupuncture had the highest incidence of adverse events. Considering International Consultation on Incontinence Questionnaire-Short Form and Incontinence Quality of Life Questionnaire, GM may be the most ideal choice. CONCLUSION: Based on NMA, GM, needling-warm moxibustion, and standard acupuncture were found to have the highest probability of being the best therapies. Due to the limitations of this study, these results should be confirmed by detailed RCTs.