Retention of urine

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Textbook Prescriptions Urogenital

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

CV3 Zhongji midline

Front-Mu of the Bladder; main point to promote urination
- Pregnancy: contraindicated
SP6 Sanyinjiao bilateral

Meeting point of the three foot yin; with CV3 regulates the bladder
- Pregnancy: contraindicated
BL39 Weiyang bilateral

Lower He-Sea of the Triple Burner; opens the water passages

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

Treatment Principle

Treat the acute symptom first by promoting urination through the bladder's Front-Mu point.

Indications

Damp-heat in the bladder: hot scanty urine or retention, lower abdominal distension, thirst without wish to drink, possibly constipation; red tongue with yellow coating at the root, rapid or thready rapid pulseDamaged channel qi (after trauma or lower abdominal surgery): dribbling or complete retention, distending lower abdominal pain; purple spots on the tongue, thready rapid pulseKidney yang deficiency: weak dribbling stream, pallor, listlessness, chilliness, weak lower back and knees; pale tongue, thready pulse weakest at the proximal position

Method

Reducing method for the damp-heat and channel-damage types; reinforcing method with moxibustion for kidney yang deficiency.

⚠ Cautions

Acute urinary retention is a medical emergency: a painfully distended bladder needs catheterisation, and causes such as prostatic obstruction, stones, spinal cord compression or drug effects must be sought. Do not needle CV3 deeply over a full bladder; angle it downward and shallow. SP6 is contraindicated in pregnancy, and CV3 should not receive strong stimulation in pregnancy.

About

The colleges' prescription for urinary retention, centred on the Front-Mu point of the bladder, with one added point for each of three types.

Rationale

CV3, the bladder's Front-Mu, works with SP6 to regulate the bladder, while BL39, the lower He-Sea of the Triple Burner, frees the water passages. The book frames this as treating the urgent symptom first.

Clinical Notes

Damp-heat: add SP9 to clear damp-heat. Damaged channel qi: add SP10 to open the channels and collaterals. Kidney yang deficiency: add CV4 with moxibustion to strengthen kidney qi, and GV20 with moxibustion, an upper point chosen for a lower disorder.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Retention of urine, p. 366–367.

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