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Acupuncture In Unexplained Urinary
Retention And Sluggish Bowel
Muzaffar K. Awan, MD
ABSTRACT
Background Auricular therapy is used in many conditions to provide relief from symptoms and to increase patient function.
Objective To describe the use of auricular acupuncture in a patient with urinary retention and sluggish bowel of unknown etiology.
Design, Setting, and Patient A 39-year-old woman with urinary retention of 3 weeks duration requested acupuncture to relieve her bladder retention and restore voiding.
Intervention The patient's only treatment consisted of a 40-minute auricular acupuncture session. Left ear points selected were: thoracic, lumbar, and sacral vertebrae, urethra, urinary bladder, kidney, smooth muscle, cerebral cortex, and 3 parts of the trunk. Right ear points selected were: 2nd urethra, pelvic plexus, ureter, inferior mesenteric sympathetic ganglion, Shenmen, liver, and brain.
Main Outcome Measure Restoration of bladder and bowel function, including elimination of the need for self-catheterization.
Results Within an hour after treatment, the patient reported elimination of urinary retention and restoration of normal voiding function. By the 3rd day after treatment, bowel and bladder functions were at their premorbid level. This patient was followed up for 12 weeks without any relapse.
Conclusion Auricular acupuncture was effective in the treatment of this patient with unexplained urinary retention and sluggish bowel function.
KEY WORDS
Urinary Retention, Sluggish Bowel, Acupuncture, Auricular Acupuncture, Auricular Medicine
INTRODUCTION
Urinary retention in young, healthy individuals is uncommon, but if left untreated, can eventually lead to pathological changes1 in the genitourinary system, and anxiety and frustration in a patient who has to daily self-catheterize.
The use of medical acupuncture for treatment of urinary retention is not well documented in the literature. We report a case of an otherwise healthy patient experiencing new-onset urinary retention and sluggish bowels who was treated with acupuncture.
Case Report
A 39-year-old white woman developed sudden and unexplained urinary retention and sluggish bowel movements 3 weeks prior to presentation. Her complaints included mild thoracic-lumbar pain and stiffness for 2 months, along with numbness in the vaginal and rectal areas, left posterior thigh, and lateral sole of her left foot. She was initially evaluated at a local emergency department and had seen a urologist. She had been prescribed trimethoprim-sulfamethoxazole, but had to discontinue due to allergic reaction. The patient underwent radiography and ultrasonography of the pelvis and kidneys; results were unremarkable. Electromyographic and nerve conduction studies of the lumbosacral region and lower extremities performed by a neurologist also did not reveal unusual findings. Magnetic resonance imaging of the lumbosacral spine revealed mild disk degeneration with posterior annular tearing at the L5-S1 level without associated focal disk herniation or nerve root impingement. For more than 3 weeks, she had been unable to void her bladder except by self-catheterizations 2-4 times daily, and had occasionally used laxatives to evacuate her sluggish bowel.
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Figure 1. Auricular Acupuncture Points for Urinary Retention and
Sluggish Bowels2
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A. Right ear points included:
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B. Left ear points included:
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1. Urethra (2nd)
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1. Thoracic, Lumbar, and Sacral Vertebrae
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2. Pelvic plexus
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3. Ureter
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2. Urethra (1st)
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4. Inferior mesenteric sympathetic ganglion
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3. Urinary bladder
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4. Kidney
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5. Shenmen
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5. Smooth muscle tone control
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6. Liver
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6. Cerebral cortex
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7. Brain
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7. 3 Parts of the trunk
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METHODS
Auricular Acupuncture Treatment
After obtaining patient consent, the patient's only treatment consisted of a 40-minute auricular acupuncture session. In the 1st half of the session, 7 needles (Seirin J-type No. 3, 0.20 x 30 mm, with tube; Seirin Company, Tokyo, Japan) were placed in the right ear at selected points 1-7 (urethra, pelvic plexus, ureter, inferior mesenteric sympathetic ganglion, Shenmen, liver, and brain) as shown in Figure 1A. In the 2nd half of the session, points 1-7 (thoracic, lumbar, and sacral vertebrae, urethra, urinary bladder, kidney, smooth muscle, cerebral cortex, and 3 parts of the trunk) were needled in the left ear (Figure 1B).
RESULTS
The patient responded within 1 hour of her acupuncture treatment and confirmed regulation of her bladder control. She returned for follow-up 3 days later and reported ongoing regulation of her bladder and bowel functions. No treatment was necessary on the follow-up visit.
This patient was followed up for 12 weeks without any relapse.
DISCUSSION
This clinical report was challenging and unusual in its presentation because no anatomical or physiological explanation could be determined. Perhaps certain mechanisms3 are involved in some cases, not unlike this one, in which a pathophysiology cannot be established by routine diagnostic methods.
CONCLUSION
Auricular acupuncture was effective in the treatment of bladder and bowel dysfunction. These results suggest the need for further studies of auricular acupuncture in the treatment of genitourinary and bowel dysfunctions.
REFERENCES
- Schimmel HW, Penzer V. Functional Medicine: The Origin and Treatment of Chronic Diseases. 2nd ed. New York, NY: Thieme Medical Publishers; 1997.
- Pesikov Y, Rybalko S. Auricular Acupuncture: Clinical Atlas. Donetsk, Ukraine: Three Dragons Press; 1994.
- Whatmore GB, Kohli DR. The Physiopathology and Treatment of Functional
Disorders. New York, NY: Grune & Stratton; 1974.
AUTHOR INFORMATION
Dr Muzaffar K. Awan is Medical Director of the Allen Park Health Center in Allen Park, Michigan. Dr Awan is a specialist in Musculoskeletal Pain Management, Medical Acupuncture, and Physical Rehabilitation, as well as being a Primary Care physician.
Muzaffar K. Awan, MD, PT*
7105 Allen Rd
Allen Park, MI 48101
Phone: 313-381-1809 • Fax: 313-381-0721 • E-mail: mkawan@aol.com
*Correspondence and reprint requests
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