Acupuncture for Overactive Bladder and Urinary Incontinence: Evidence

Two different problems

Overactive bladder (OAB) is an urgent, frequent need to pass urine caused by bladder muscles that contract too often. [1] Stress urinary incontinence (SUI) is leaking when sudden pressure on the bladder, such as laughing or sneezing, overcomes the urethra's ability to stay closed. [1] Research on acupuncture differs for each, so this page keeps them apart. It is information only. The NHS advises seeing a GP about any type of urinary incontinence. [2] In an emergency call 911.

Start with first-line care

The NHS says conservative treatments that do not involve medicines or surgery are tried first for incontinence, including lifestyle changes, pelvic floor muscle training and bladder training. [3] It adds that research shows pelvic floor muscle training can benefit everyone with urinary incontinence. [3] Acupuncture is best read as a possible add-on to that care, not a replacement. See Pelvic Floor and Pelvic Pain.

Evidence at a glance

Labels used: promising but limited, mixed, insufficient evidence.

Overactive bladder

The 2022 Cochrane review included 15 studies with 1,395 people. All had some concerns about bias, and blinding of participants happened in only 20% of studies. [4]

• Versus sham. Five studies compared real and sham acupuncture, and the review said it is uncertain if there is any difference in cure or improvement. [4]
• Versus medicine. Eleven studies compared acupuncture with medicine. The review reported low-certainty evidence of a slight increase in cure or improvement, and fewer minor side effects. [4] Because blinding of participants was achieved in only 20% of studies, expectations may shape self-reported symptoms.
• Safety. Studies in the sham comparison reported no major adverse events, but the authors noted such events are rare and the numbers may be too small to detect them. [4]

A 2025 umbrella review of seven earlier reviews found that six were rated critically low in confidence, and one low, so its authors urged careful reading. [5] A 2025 trial in postmenopausal women with OAB (147 people) compared electroacupuncture at two frequencies with manual acupuncture and found no significant difference in the main outcome, with no serious adverse events reported. [6] That trial had no sham group, so it cannot say whether any of them beat sham.

Stress urinary incontinence

A 2017 JAMA trial randomized 504 women with SUI at 12 hospitals in China to 18 sessions of electroacupuncture or sham electroacupuncture with no skin penetration. At 6 weeks the real group leaked less on a one-hour pad test (a fall of 9.9 g versus 2.6 g). [7] Treatment-related adverse events were mild and similar in both groups (1.6% and 2.0%). [7] A 2023 trial of 304 women added electroacupuncture or sham to pelvic floor muscle training and found a larger fall in leakage with the real treatment (9.8 g versus 5.8 g). [8]

Both trials were multicenter, sham-controlled and took place in China. They are single-country studies of one technique, and the authors of the JAMA trial said long-term efficacy and the mechanism need further research. [7] See Electroacupuncture for what that method involves.

Who should take extra care

NCCIH says relatively few complications have been reported, but poorly delivered acupuncture can cause infections, punctured organs and nervous system injury. [9] The NHS lists blood thinners, bleeding risk, and skin conditions or infections as reasons acupuncture may not be safe. [10] Extra cautions with electroacupuncture are covered in Acupuncture Side Effects and Precautions. Causes of urgency can include urinary tract infections and conditions affecting the bladder, so get a diagnosis first. [1]