Urinary Retention refers to the condition where the bladder is filled with urine but cannot be emptied normally. It can be classified into acute urinary retention and chronic urinary retention based on its history and characteristics. Acute urinary retention occurs suddenly, with the bladder being suddenly filled with urine and unable to be emptied, causing severe pain and discomfort for the patient. Emergency treatment is often required. Chronic urinary retention develops slowly, with a longer course of the disease. The bladder, filled with urine, can be felt in the lower abdomen, but the patient is unable to empty the bladder. Due to the long-term presence of the disease and adaptation to the pain, the symptoms may not be severe.
Clinical Manifestations
Acute urinary retention occurs suddenly, with the bladder being filled with urine and unable to be emptied. The patient experiences severe pain and restlessness. Sometimes, a small amount of urine may overflow from the urethra, but it does not alleviate the lower abdominal pain.
Chronic urinary retention is often characterized by difficulty in urination, frequent urination, a constant feeling of incomplete emptying, and occasionally, urinary incontinence. Although some patients do not show obvious symptoms of chronic urinary retention obstruction, they may already have significant upper urinary tract dilation, hydronephrosis, and even symptoms of uremia, such as weakness, anemia, breath with a urine odor, loss of appetite, nausea, vomiting, anemia, increased serum creatinine and blood urea nitrogen levels, etc.
Chinese Massage Treatment
Massage treatment should focus on promoting urination and clearing dampness and heat. Instruct the patient to lie supine with legs bent, and use the thumb to knead the Zhongji point and bilateral Yinlingquan points in a counterclockwise direction for 5-10 minutes each, until the patient feels a sore and swollen sensation. When kneading the Zhongji point and Yinlingquan points, the pressure should be directed towards the feet. Then instruct the patient to assume a prone position, and use the thumb to knead the Bladder Shu point for 5-10 minutes, until the patient feels a sore and swollen sensation. The pressure applied to the Bladder Shu point should be directed towards the feet.
Zhongji is an acupoint of the Conception Vessel and a meeting point of the Conception Vessel and the Foot Taiyin Spleen Meridian. Kneading this point can consolidate the lower Yuan, help with qi transformation, regulate the blood chamber, warm and supplement the essence palace, clear the lower Jiao, and promote bladder smooth muscle contraction. Zhongji is the alarm point of the bladder. The Bladder Shu point is the Back-Shu point of the bladder. The combination of these two points can help to unblock the bladder's qi mechanism and promote urination. Yinlingquan is an acupoint of the Foot Taiyin Spleen Meridian. Kneading this point can generally clear and benefit the Spleen Meridian and resolve dampness and heat. The combination of these points can help to unblock the qi mechanism and clear dampness and heat, thereby achieving the effect of promoting urination.
Acupuncture Treatment
Acupuncture can be performed on the Yinlingquan, Zusanli, Sanyinjiao, Guanyuan, Zhongji, Shuidao, and other points to facilitate urinary discharge within a relatively short period of time. Alternatively, Chinese massage techniques can be used by using the palm and fingers to gently press on the front wall and bottom of the patient's bladder for dozens of times, which can enhance the contraction function of the bladder's smooth muscle and often promote urination. Pressure can also be applied to the Guanyuan, Qihai, and Zhongji points using the fingers with moderate and even force, while instructing the patient to exert force to force urine out. In addition, medication such as Chinese herbal medicine that promotes diuresis and relieves stranguria can be used. Applying heat to the lower abdomen can also help treat urinary retention. If none of the above methods are effective, catheterization can be used to remove urine from the body and relieve the pain.
Chinese Herbal Formulas
Method 1:
【Pattern】Qi deficiency and failure to control urination.
【Treatment Principle】Tonify qi and promote urination.
【Formula】12g Astragalus (stir-fried), 9g Rhizoma Chuanxiong (stir-fried), 2g Cinnamon bark (added later), 9g Herba Schizonepetae, 3g Amber powder (taken in a flush), 3g Licorice (twig).
【Usage】Decoction, 1 dose per day, taken twice a day.
Method 2:
【Pattern】Evil heat invades the lower Jiao, kidney gate fails to open and close, and bladder qi transformation is weak.
【Treatment Principle】Warm and nourish with minimal fire, ascend clear and descend turbid.
【Formula】10g Anemarrhena, 10g Coptis, 10g Cinnamon bark, 10g Prepared Rehmannia, 10g Fructus Aurantii Immaturus, 45g Rhizoma Chuanxiong.
【Usage】Decoction, 1 dose per day, taken twice a day.
