Chinese Medicine for Urinary Retention and BPH
Chief Complaint: Urinary retention
Western Diagnosis: Urinary retention due to benign prostatic hypertrophy
Medical History: 68 year old male experiencing increased frequency of urination, especially at night. After urinating, he felt some of the urine remained. Over time, increasing effort was needed to urinate and the urine stream became thin. Enuresis occurred occasionally. Recently, after becoming tired, he was unable to pass urine, resulting in lower abdominal discomfort. The abdominal distention was relieved by catheterization combined with drugs and Chinese herbal medicine. Two days later, voluntary urination was still impossible, and catheterization was repeated. Surgery was recommended, but the patient refused, opting instead for acupuncture.
Questioning exam: No urgency or pain or hematuria. generally weak and debilitated. Shallow breathing. Aversion to cold. History of low back pain and tinnitus.
Pulse exam: The pulse was deep and wiry, and both rear positions were weak.
Tongue exam: His tongue was pale and toothmarked with a slimy white coat.
OM Diagnosis: Urinary retention d/t Kidney Yang deficiency. Underlying deficiency of Qi and Yang leading to lack of control in the lower jiao. There is also evidence of his Kidney not grasping the Qi leading to shallow breathing
Treatment Principle: Tonify the Kidney. Warm the Yang. Nourish the Qi.
Point Prescription: Ub 39 to regulate the flow of urine. Ub 22 as it is the back shu of the San jiao. Ren 6 to fortify the Yang. Ren 3 as it is the front mu of the Ub. Sp 9, Sp 6, and Ub 28 need to be used to address the acute blockage.
Herbal Formula: Jin Gui Shen Qi Wan, Nan Xing Bu Shen Wan
It is important to use draining herbs, blood movers, and downward draining herbs.
Lifestyle Prescription: Decrease salt intake. Temporarily decrease water intake. Eat foods that tonify the kidney and nourish Yang. Use saw palmetto.
Results: The patient was able to voluntarily pass urine again and is better able to empty his bladder. He has avoided surgery. Though he still suffers from BPH it has not become significantly worse.