Dr Maggie Ju Acupuncture for pain relief

Bladder is located in the lower abdomen and it is for storing urine. As the urine goes into the bladder, bladder muscles relax so that it can expand. As the bladder empties during urination, the muscles contract to squeeze the urine out through the urethra.

Some condition can cause bladder pain.  It is very painful as urinate. The most common condition causing urination pain is interstitial cystitis. Interstitial cystitis (IC) is a chronic condition in which the bladder becomes inflamed and irritated. The inflammation stiffens the bladder wall, and makes it difficult for the bladder to fully expand when filling with urine. Patients with IC have painful urination and have to urinate more frequently and have a feeling of urgency to urinate, though there is no much urine each time. The main symptom of IC is pain which is generally located in the lower back, abdomen or groin region. Bladder pain is often recurring. 

Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic bladder condition. It is a feeling of pain and pressure in the bladder area and the symptoms have lasted for more than 6 weeks, without having an infection or other clear causes. Symptoms range from mild to severe. For some patients the symptoms may come and go, and for others they don't go away. The pain may be worse when the bladder is full and may be temporarily relieved after urination.  The pain could be worse during periods or after having certain foods or drinks. IC/BPS is not an infection, but it may feel like a bladder infection. Women with IC/BPS may feel pain when having sex.  Some patients feel pain in other areas, such as the urethra, lower abdomen, lower back, or the pelvic or perineal area (in women, behind the vagina and in men, behind the scrotum). Women may feel pain in the vulva or the vagina, and men may feel the pain in the scrotum, testicle, or penis. This condition is poorly understood.

Apart from the pain, it is also accompanied with problems of urination. Another common symptom is urinary frequency. Frequency is the need to pass urine more often than normal. A patient with IC/BPS often has to urinate frequently both day and night, more frequent urination than normal, pain when passing water, waking up quite a few times during the night to urinate. The average person urinates no more than 7 times a day and does not have to get up at night more than once to use the bathroom. Urgency to urinate is also a common IC/BPS symptom. Some patients feel sudden, strong urges to urinate and an urge that never goes away, even right after voiding. Physical or mental stress can make the symptoms worse.

Acupuncture can effectively treat IC/BPS syndrome. This is studied by many researchers.

Recurrent urinary tract infections, acupuncture can help

Acute lower urinary tract infections (UTIs) are common in adult women, and as many as 6% of members of the adult female population experience 3 or more episodes during a given year. Women with frequently recurrent cystitis may need prophylactic antibacterial treatment, however if the infection is recurring and this causes development of antimicrobial resistance. Acupuncture is used to treat UTIs. Recently there was a research from Norway which studied the effect of acupuncture on recurring UTIs in women. In this study, it included women aged 18-60 year old who had to have had 3 or more episodes of distal urinary symptoms (i.e., dysuria and frequent urination or suprapubic discomfort) during the previous 12 months, and at least 2 of these episodes had to have been diagnosed and treated as acute lower UTIs by a medical doctor. Acupuncture was offered twice a week for 4 weeks. Following treatment, 73% of women in the acupuncture group were free of UTIs during the 6-month observation period.  Several episodes of acute distal urinary symptoms were noted in which bacterial cultures either were not obtained or were negative. One third as many episodes per person-month occurred in the acupuncture group as in the control group.  Women in the acupuncture group experienced a 50% reduction in residual urine after 6 months relative to baseline, whereas women in the untreated group exhibited no significant change in residual urine. This study indicated that acupuncture treatment may be effective in preventing recurrent lower UTIs .  

Overactive bladder, acupuncture can help

Overactive bladder is a condition in which the increased urination frequency with other symptoms are found. The symptoms include more frequent urination in the day and night; urine urgency which is sudden, strong need to urinate and leak urine. It could be painful, when one pass the urine.

Overactive bladder is one of the most common urinary tract problems in women. Women have to go to bathroom frequently, feeling severe urge to urinate and feeling fullness of the bladder. This condition is not life threatening, but it affects quality of life in women. At minimum, 11 to 16 million women in the United States cope on a daily basis with symptoms that include sudden strong urges to urinate, difficulty delaying voids, frequent urination, and in many cases involuntary loss of urine when urgency strikes. This causes much stress in women. However the treatments are not satisfactory. Studies have shown that acupuncture can help reducing the symptoms. A recent review from journal Medicine (Baltimore) assessed the efficiency and safety of acupuncture for overactive bladder. 794 patients with 10 randomised controlled trials were included in the study. The result has shown that acupuncture could decrease urination frequency and improve quality of life. Wang S et al studied long-term effect of acupuncture for overactive bladder. At least 5 years were evaluated. 106 patients participated the study. Evaluation was based on a questionnaire including questions on storage, voiding, and postmictutrition syndromes. The mean treatment sessions were 21.2. The results showed that complete resolution was 42.5% and 50% improvement was 85.5%.  62 patients were followed up for 5-10 years. 35 of these 62 patients maintained the posttreatment effect; 18 changed from better to complete resolution; 7 got back to less than 50% improvement; 4 changed less 25% improvement.

Forde et al from Department of Urology, Weill Cornell Medical College, New York analysed current research data for the role of acupuncture in managing overactive bladder. They analysed two case series and six comparative trials. All studies demonstrated subjective improvement in  symptoms, and some reported objective improvement in urodynamic studies. Their comparative trials showed the benefit of acupuncture to be comparable with antimuscarinic treatment.