Acupuncture Treatment and Points used for Urological Problems
It is important to note that Percutaneous Posterior Tibial Nerve Stimulation (PTNS or electroacupuncture on SP6) is only one element of acupuncture treatment for urological problems. A wide variety of acupuncture points and stimulation methods are available to influence urological function.
Kitaoji et al. examined the efficacy of acupuncture on 11 overactive-bladder patients. Acupuncture needles were inserted at the BL33 points (bilateral), and the needles were manually stimulated for 10 minutes. After 4 to 12 acupuncture sessions, 7 patients experienced a complete or partial control of urinary-urge incontinence. Acupuncture significantly increased their maximum bladder capacity and bladder compliance. It should be noted that the BL33 point used in this study is traditionally used for various urological conditions. It is located at the S3 sacral nerve root, which governs detrusor muscle contractions. The S3 nerve has therefore been frequently targeted in various forms of neuromodulation treatments. Other acupuncture studies have shown improvements in subjective and/or objective parameters in overactive-bladder patients through the use of a variety of acupuncture points (e.g., LI11, ST36, BL23, BL28, BL31, BL32, BL39, KI3, GV4, CV3, CV4, CV6). Unlike neuromodulation techniques, most of which attempt to stimulate only one point or area of the body, acupuncture traditionally utilizes a much wider variety of points across the body (see Table 1a & 1b). Interestingly, most of the acupuncture points traditionally used to treat urinary incontinence are located within the nerve segments or dermatomes targeted by neuromodulation methods. Most of the aforementioned neuromodulation methods attempt to influence detrusor muscle functions by stimulating the root or dermatomes of S2-S4 or the tibial nerve, which contains sensory-motor nerve fibers originating from spinal roots L4 through S3 (See Fig. 1 and Fig. 2).
Table 1a and 1b. Prescriptions of Acupuncture Points for Urinary Incontinence Described in Acupuncture Textbooks and Chinese Medicine Classics
It should be noted that traditional acupuncturists administer treatment on an individual basis, using combinations of the above-mentioned points. In addition, many traditionally trained acupuncturists not only utilize the points related to urinary organs but also use points to address the patient’s underlying physical and/or emotional imbalances. This approach could be highly important, especially when considering that a previous PTNS study has strongly suggested that the success of PTNS treatment depends upon the patient’s emotional state.
Figure 1: Locations of Acupuncture Points Used for Urinary Incontinence in Relation to Anterior Dermatomes
Figure 2: Locations of Acupuncture Points Used for Urinary Incontinence in Relation to Posterior Dermatomes