Treatment of Urinary Incontinence Due to Incomplete Spinal Cord Injury With Acupuncture and Percutaneous Electrical Nerve Stimulation: Two Cases and Literature Review

Abstract

ABSTRACT

Background:

Urinary incontinence related to thoracolumbar upper motor neuron spinal cord injuries has been reported to have poor long-term prognosis for recovery. There is limited research on the use of acupuncture for this condition.

Objective:

To describe acupuncture therapy for urinary incontinence due to spinal cord injury.

Design, Setting, and Patients:

Two men (63 and 84 years) presented with incontinence following back injury or chronic back pain. Both men had received pharmacological agents and surgical intervention, with minimal improvement.

Intervention:

For patient 1, electroacupuncture at GB 25 (negative) to the crossed handles of BL 23 and BL 52 (positive), bilaterally, for 15 minutes, followed by Kidney-Bladder distinct meridian input focused to the crossed handles of BL 31 and BL 34, bilaterally, for another 15 minutes. BL 31 and BL 34 as well as GV 1 were also stimulated. For patient 2, an approach identical to that of patient 1 was performed bilaterally for 15 minutes. Percutaneous electrical nerve stimulation treatment was performed bilaterally for 25 minutes from the crossed handles of T9 and L1 to S1 (negative), and from the crossed handles of S2 and S4 (positive) to the ipsilateral suprapubic region.

Main Outcome Measures:

Patient report of incontinence, related symptoms, and use of pharmacotherapy.

Results:

At 5-month follow-up, patient 1 was completely continent of urine and could sleep up to 7 hours at night without voiding. After the third treatment, patient 2 discontinued pain medication and bowel and bladder continence were greatly improved. By the 15th treatment, his urinary incontinence had resolved. The authors review the literature pertaining to acupuncture treatment of neurogenic bladder due to spinal cord injury.

Conclusions:

Although there are limited data on this topic, acupuncture in these cases produced favorable outcomes in patients with neurogenic bladder that was previously refractory to pharmacological and surgical interventions.