Wednesday, 21 November 2018 14:29

Can acupuncture help an overactive bladder

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Q: I have suffered from an overactive bladder for about 12years. I need to go to the toilet about every hour and every two hours at night. I need to get this problem under control, as I have limited abilities to do as I want. I have had to cancel a holiday as waiting at the airport would have been too stressful not to mention being on the plane and needing the toilet so much. I would value your help as I cannot carry on like this. I am 67 and want to claim my life back if possible. 

A: We have been asked about this on a number of occasions, and a typical answer has been:

As our factsheet shows 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/urinary-incontinence.html

there is some evidence to suggest that urgency of urination can be helped by acupuncture, although there is not yet anywhere near enough evidence to make substantive claims here. If you search the internet there are a number of studies such as this one

http://www.ncbi.nlm.nih.gov/pubmed/15994629

which offer some hope.

However, we have to remind ourselves sometimes that traditional acupuncture has been dealing with problems like this for over 2000 years, and has a very sophisticated process for understanding patients' symptoms against a backdrop of an entirely different conceptual framework. The understanding of the body as a system of energy, 'qi', in flow and the concepts of yin and yang to describe its flow and inter-relationships is very alien to the western ear. However, the rather wider understanding of organs as functional units with effects on body mind and spirit, and the underlying premise that symptoms are alarm bells, not the problem itself, can sometimes offer possibilities for understanding a problem in a far wider context. This will often be corroborated by other problems which a patient suffers and by diagnostic signs which the practitioner sees, and can often lead to a situation where a practitioner can tell the patient about symptoms that they haven't yet mentioned. If the problem is a part of a recognised syndrome or pattern of symptoms a practitioner will be able to give a clear idea of prognosis. Even if it doesn't the attempt to re-establish balance in the system can also have an effect on individual symptoms.

We recommend that you talk to a BAcC member local to you an ask for their advice in a brief face to face consultation whether they think that they can help you. We trust that they will give you an honest assessment, and refer you on to other modalities of treatment if they felt that these offered a better prospect of success.

We have had another look at the research evidence which has emerged since we wrote this response, and there are two more papers which make encouraging noises

http://www.ncbi.nlm.nih.gov/pubmed/25399241

http://www.ncbi.nlm.nih.gov/pubmed/25033919

and evidence of a systematic review about to take place. This is a survey of all papers on the subject which is regarded very highly within conventional medicine since it irons out anomalies in smaller samples.

One of our members has studied this problem for several years and given presentations at our research gatherings and conferences, so we are confident that there is something of importance emerging in the use of traditional acupuncture in this field. However, each individual person is different, however similar their symptoms may be, and the strength of Chinese medicine is that treatment is tailored to the unique needs of the patient, not simply offered as a one size fits all option. Visiting a BAcC member local to you would seem to us to be your best option. Here you will get advice for your own unique presentation.  

This is, as you can see, a 'stacked' answer, two together, and when we receive enquiries which we have answered before we often quote them and look at any more recent developments. There is nothing more to add, with the systematic review still being undertaken.

However, there is a treatment which is not really acupuncture as such caller percutaneous posterior tibial nerve stimulation of which we said in reply to someone else

The technique  is called percutaneous posterior tibial nerve stimulation, about which you can read here:

https://www.nice.org.uk/guidance/ipg362/chapter/1-Guidance


It is not really an acupuncture technique as such, at least it certainly is not a part of the ancient traditional Chinese medicine which we all practise. It is a modern technique using needles as electrodes which, as is often the case in modern developments of acupuncture, is described as working 'by a mechanism which is not yet properly understood.' It may well be that a traditional acupuncturist has decided to add this to their repertoire, but it is not a part of our core training.

This is not something which we would normally offer, but there may be practitioners in your area who do. If all else fails this would be worth a go. Another left field suggestion might be NLP hypnotherapy, a specific form of hypnotherapy of which we have often heard good reports. Where a problem starts to generate itself, i.e. the fear of needing to go can often generate the urge to go, there are a number of ways to try to break the cycle. Western medicine offers one or two drug treatments which suppress the urge to go for a number of hours, but we are not convinced of the safety of using this as a long term strategy. Something like hypnotherapy, which can break the cycle of urge and frequency and give a person some control back, may be an option worth exploring.

Obviously, though, we believe that traditional acupuncture may be well worth a go, and hope that you find some relief from this life-changing situation

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