Abstract / Summary
Objective: Patients with non-muscle-invasive bladder cancer (NMIBC) often experience lower urinary tract symptoms (LUTS) after postoperative intravesical instillation, impairing quality of life and treatment adherence. This study explored the effects of traditional Chinese medicine (TCM) acupoint application on postinstillation LUTS and quality of life.
Methods: In this randomized, single-blind, crossover exploratory study, patients receiving postoperative intravesical instillation alternately underwent conventional instillation or instillation following TCM acupoint application, separated by a 1-week washout period. Primary outcomes included visual analog scale (VAS) scores and 24-h voiding diary parameters. Secondary outcomes included EORTC QLQ-C30 and FACT scores. The outcome measures were analyzed using linear mixed-effects model (LMM).
Results: LMM analysis showed that, compared with conventional intravesical instillation, acupoint application was associated with significant reductions in the total number of voiding episodes within 24 h, daytime voiding frequency, episodes of urinary urgency, and episodes of dysuria following intravesical instillation (all p < 0.05). VAS scores and nocturnal voiding frequency also showed decreasing trends, although the differences were not statistically significant (p > 0.05). Compared with conventional intravesical instillation, acupoint application resulted in a significant improvement in the physical functioning score of the EORTC QLQ-C30 (p < 0.05). Improvements were also observed in global health status and the role, emotional, cognitive, and social functioning domains; however, these differences did not reach statistical significance (p > 0.05). With respect to the symptom domains, scores for fatigue, pain, insomnia, and appetite loss also showed trends toward improvement after acupoint application, but the differences were not statistically significant (p > 0.05). No statistically significant differences were observed in any functional domain of the FACT scale between acupoint application and conventional intravesical instillation (p > 0.05).
Conclusion: This exploratory study provides preliminary evidence that TCM acupoint application may have the potential to alleviate LUTS in patients after surgery for bladder cancer, while also showing a trend toward improving patients' quality of life. These findings provide preliminary evidence to support the feasibility of subsequent studies, optimization of study design, and estimation of sample size for future trials.
Trial registration: Chinese Clinical Trial Registry: ChiCTR2300074736.