Electroacupuncture Improves Voiding Function in Patients with Neurogenic Urinary Retention Secondary to Cauda Equina Injury: Results from a Prospective Observational Study

Abstract

Objective To report the therapeutic effectiveness and feasibility of electroacupuncture (EA) treatment in patients with urinary retention which is caused by cauda equina injury and refractory to conventional conservative treatments. Methods From 9 August 2007 to 10 May 2010 prospective evaluation was carried out in 15 patients with neurogenic urinary retention secondary to cauda equina injury who underwent EA treatment at bilateral points BL32, BL33 and BL35. All patients received fi ve sessions of EA treatment each week for the fi rst 4 weeks, three sessions a week for the following 2 weeks, and then were followed up for 6 months. Voiding abilities, postvoiding residual urine volume (RUV) and maximum urinary fl ow rate (Qmax) were documented as outcome measures. Results After 6 weeks' EA treatment, 10/15 enrolled patients regained their self-voiding ability, and the mean postvoiding RUV for all patients decreased by 303.6±148.8 ml. In nine patients with documented data, Qmax increased by 11.0±6.3 ml/s. In nine patients, voiding diffi culties changed from severe to mild. At the end of 6 months' follow-up, 8/10 patients retained their regained self-voiding ability, whereas two patients had lost their voiding ability again. Conclusion The results indicate that the EA treatment may have longlasting therapeutic effectiveness in the management of neurogenic urinary retention secondary to cauda equina injury.

Electroacupuncture Improves Bladder and Bowel Function in Patients with Traumatic Spinal Cord Injury: Results from a Prospective Observational Study

“…The results were consistent with our previous findings in which 10 out of 15 patients with cauda equina injury resumed voiding abilities and were urinary catheter-free after a similar EA treatment protocol [10]. Honjo et al [9] found that EA at S2 was found to be effective in improving bladder control decreasing incontinence frequencies in patients with detrusor hyperreflexia.…”

“…In the present study, EA was found to significantly decrease postvoid RUV both after treatment and during followup. These results echo with our previous findings in patients with cauda equina injury patients [10]. The decrease in postvoid RUV reflects the improvement of voiding ability with EA in patients with neurogenic bladder.…”

“…Similarly, manual acupuncture was found to induce resolution of urinary incontinence in 15% of patients with SCI-induced detrusor hyperreflexia [9]. In addition, the results of our previous case series study [10] and the study by Honjo et al [9] indicate that EA could improve voiding abilities in patients with SCI. Among the aforementioned research studies, effects of EA on both bowel and bladder functions were only reported in the study by Wong et al [8].…”

Effects of Electroacupuncture on the Daily Rhythmicity of Intestinal Movement and Circadian Rhythmicity of Colonic Per2 Expression in Rats with Spinal Cord Injury

“…Previous studies showed that acupuncture and electroacupuncture (EA) improved bowel dysfunction and colon motility in patients with SCI, without significant side effects [16–19]. Nevertheless, whether EA can regulate the biological clock of the intestine when deprived of the influence of the central nervous system is still unclear.…”

Acupuncture for Preventing Complications after Radical Hysterectomy: A Randomized Controlled Clinical Trial

“…Some other researches also indicated that acupuncture was helpful for recovery of bladder dysfunctional disorders, including urinary incontinence and retention [17]. The possible mechanism for bladder recovery is the nonselective effect of acupuncture stimulation (electrical/mechanical) at S2–S4 where the pelvic splanchnic nerves and pudendal nerve arise [18, 19]. Acupuncture has positive effects on nerve regeneration process and provides an alternative treatment on nerve-injured patients [20, 21].…”