Background: Urinary incontinence is one of the most distressing common symptoms in patients with prostate cancer after surgery. Auriculotherapy has been shown to improve a variety of symptoms effectively and has a certain potential in managing urinary incontinence, but the relevant studies are few and inconclusive. This study aimed to assess the effectiveness of auriculotherapy on urinary incontinence in men with prostate cancer.

Methods: Participants were recruited from the urology ward of a tertiary hospital between October 2023 and April 2024. A total of 114 men who underwent radical prostatectomy were randomly assigned to the usual care (n = 38), sham-auriculotherapy (n = 38), or true-auriculotherapy (n = 38) groups. All groups received pelvic floor muscle training, and the intervention groups received four additional sham-auriculotherapy or true-auriculotherapy. The primary outcomes were the International Advisory Committee on Urinary Incontinence Questionnaire short form (ICIQSF) score and clinical effective rate, the secondary outcomes included the continence rate, pad usage, urinary incontinence severity, urinary incontinence episodes, and quality of life. Data were collected at week 2, week 4, week 8, and week 12 after surgery. Generalized estimating equations were applied for outcome comparison.

Results: The true-auriculotherapy group had significantly lower ICIQSF scores (β = -1.93, 95% CI: -3.21, -0.65, P = 0.030), higher clinical effective rates (OR = 1.12, 95% CI: 1.04, 1.20, P = 0.003), lower pad uses (β = -0.50, 95% CI: -0.93, -0.07, P = 0.023), and higher Incontinence Quality of Life Instrument scores (β = 3.82, 95% CI: 1.55, 6.09, P = 0.001) than usual care group, while no significant difference was noted between the sham-auriculotherapy and usual care groups. The continence rates were not significantly different among the three groups. In terms of the simplified version of the Expanded Prostate Cancer Review Index, the true-auriculotherapy exhibited greater improvements in the "urinary incontinence", "urinary irritation /obstruction", and "hormonal" domains than usual care at week 12, but showed no significant differences regarding "bowel" and "sexual" domains. The sham-auriculotherapy was superior to usual care only in the "hormonal" domain and was not significantly different in the other domains.

Conclusion: Auriculotherapy is a relatively simple, low-cost, low-risk, and effective nonpharmacological approach for alleviating urinary incontinence. Regular and consistent acupressure is essential to maintain the effectiveness of auriculotherapy. The long-term effectiveness and mechanism of auriculotherapy need to be further explored.

Trial registration: ChiCTR2300071700, available on the Chinese Clinical Trial Registry ( www.chictr.org.cn ). The first registration date was 23/05/2023.