Acupuncture for the treatment of pediatric nocturnal enuresis: A systematic review and a meta-analysis of randomized and non-randomized studies

IntroductionNocturnal enuresis is a common clinical condition in the pediatric population. The aim of this study was to assess the effectiveness of acupuncture treatment on pediatric nocturnal enuresis.MethodsThe search of publications using “acupuncture” and “enuresis” or “bedwetting” as keywords was performed in 6 databases. To be included studies had to (1) compare acupuncture with conventional treatment or placebo; (2) investigate a pediatric sample; and (3) provide results at the end of treatment or follow-up. Languages included were English; Italian; and Chinese. Analysis was performed according to PRISMA guidelines. Primary outcome was reduction in wet nights. Side effects and dropouts were secondary outcomes.ResultsWe included 10 studies (7 randomized controlled trials and 3 non-randomized controlled trials) covering a total of 888 patients. A favorable, but non significant, effect of acupuncture compared with conventional care and placebo emerged. The type of acupuncture was the main source of heterogeneity. No statistically significant differences emerged across non-randomized and randomized studies. No difference was found in dropouts. Side effects in the acupuncture group were minor but rarely reported.ConclusionsAcupuncture seems to be an effective option for the treatment of nocturnal enuresis, though further large randomized trials are needed because no statistically significance emerged and low quality of the included studies might have overestimated results. Acupuncture treatment seems feasible and with minor side effects.