Learning & Resource Center Articles
Acupuncture Treatment of Incontinence following Prostate Cancer Surgery
By: Joseph Alban MS, L.Ac
Prostate cancer is the second most common cancer diagnosed in American men. According to the American Cancer Society, there will be over 180,000 new cases diagnosed in American men during this year alone. The good news is that prostate cancer has a very good prognosis when diagnosed and treated in the early stages with surgery. Which is why regular screening and early detection is so important. However, surgery may lead to side effects such as frequent and nighttime urination, incontinence, and erectile dysfunction. But there is more good news, acupuncture can effectively reduce these symptoms and improve your quality of life.
Traditional Chinese Medicine (TCM) has been treating problems of urination and sexual dysfunction for over than 2000 years. Starting in the ancient text called Elementary Questions, TCM has described the diagnosis and treatment many syndromes of incontinence as well a frequent and painful urination. Obviously there was no surgery for prostate cancer at that time, but the modern practice of Chinese medicine has shown that those same principles of diagnosis and treatment are effective when applied to the symptoms caused by prostate cancer surgery.
TCM, Frequent Urination, and Sexual Function
Traditional Chinese Medicine works by correcting imbalances in the body. Treating the imbalance does not just treat the symptoms or mask the condition, but rather corrects the root of the problem by encouraging self-healing of the body. Generally, the root cause of incontinence and sexual function is an imbalance of the kidneys. Sometimes an imbalance of the spleen or liver is also involved. Please note that while the organ names and some of the functions are the same in both TCM and Western medicine, a dysfunction of the TCM kidney, spleen, and liver does not mean a disease in the western medicine organ.
In TCM, the kidneys are responsible for both sexual function and water metabolism. It is said that the kidney "governs water." In other words, the kidneys regulate urination. Just like in western medicine, the kidneys filter out the urine. But unlike western medicine, kidney qi (or energy) also contributes to the ability to hold urine in the bladder as well as the ability to urinate completely. The kidney is also the main contributing organ for libido and sexual function.
The functions of the kidney can be described in terms of yin and yang. The ability for the bladder to sufficiently hold urine is a yin function. When there is too little kidney yin, the bladder cannot hold urine and may result in stress and urge incontinence. Stress incontinence occurs when one's bladder leaks while laughing, coughing, or sneezing while urge incontinence is the sudden and urgent need to pass urine. Other symptoms of kidney yin deficiency are night sweats, red face, thirst, frequent nighttime urination, a rapid pulse, and a red tongue.
The ability to smoothly urinate is a yang function. When there is too little kidney yang, the bladder cannot properly control the opening and closing of the urethra, which can lead to inhibited urination. A problem with kidney yang may lead to overflow incontinence, which is described as difficulty in starting urinating and then there is dribbling after it begins. Other signs of yang deficiency are a feeling of cold in the body, possible loose stool, fatigue, a slow pulse, and pale tongue. Impotence and poor libido is also a sign of kidney yang vacuity. Just as it is common to have many types of incontinence at the same time, it is also common for both kidney yin and yang to simultaneous be damaged.
The spleen is also an important organ in water metabolism and urination. If the frequent urination is accompanied by extreme fatigue especially in the morning, loose stools, poor digestion, and a pale swollen tongue, the imbalance may be in the spleen. If it is worsened by stress or anger, the liver may also be involved.
Another factor post prostate surgery is qi and blood stagnation. Qi and blood naturally circulate in the body. Injury or trauma can cause them to slow down or stop, what is called stagnation. This is common following surgery of any kind. It can also develop from any chronic disease and may naturally occur as one ages. Following prostate surgery, it is often a factor in recovery and should be treated with acupuncture and possibly Chinese herbs. Signs of blood stagnation can be pain, dark spots on the tongue, or a purplish hue in the tongue color. The urine may also have blood in it, and it may be difficult to completely void. Blood stagnation usually does not occur alone, but is combined with kidney or spleen vacuity.
Acupuncture and Chinese Herbal Treatment
The acupuncture and Chinese herbal treatment are focused on correcting the root imbalance in the body. The treatment is usually once or twice a week with acupuncture and a treatment series is usually 10-12 sessions. The treatment should increase one's ability hold urination, decrease number of times one urinates at night, decrease urinary urgency, and create a smoother urine flow. In addition, patients can see an improvement in sexual function over the same period of time.
Acupuncture points such as Ren 4 and 6 on the lower abdomen as well as Bladder 23 and Du 4 on the lower back all tonify the Kidney. Kidney 7 can be added to tonify the yang, while Kidney 2 will be used if there is more yin deficiency with heat. Other points, such as Ren 3 and Bladder 64 can directly tonify the Bladder and help with incontinence. If the spleen is involved, Spleen 3 and 9 will be helpful. If the liver is in disharmony, Liver 5, 3, or 2 can help move the qi and open the channels in the genitals.
Also, many points on the lower back and sacrum help move the Qi and blood, such as Bladder 32 and 33. Spleen 6 also helps move qi and blood and can be used. Moxibustion, the warming of acupuncture points with a smoldering herb called ai ye, can be helpful for incontinence and libido. Warming the lower abdomen and lower back can be very effective for this problem because moxibustion both warms yang while moving Qi and Blood stagnation.
Herbal formulas such as liu wei di huang tang can be used for kidney yin deficiency, while ba wei di huang tang is effective for yang deficiency. If the root imbalance is in the spleen, wu ling san or bu zhong yi qi tang can be a very effective formula. For blood stagnation, herbs such as dan shen and wang bu liu xing can be added. When taking Chinese herbs, it is very important to get diagnosed and treated by a trained practitioner of Chinese medicine.
Acupuncture is also very useful for support if you are undergoing chemotherapy, radiation, or hormonal therapy. The treatment would be modified for the specific presentation to boost qi or clear heat.
To learn more about how acupuncture can help you reduce the symptoms from prostate surgery, it is best to find an acupuncturist with experience in treating frequent urination and sexual dysfunction. Find an acupuncturist near you!
2. Wiseman N, Feng Y. Practical Dictionary of Chinese Medicine. Brookline, MA: Paradigm; 1998:583.
3. Wiseman N, Ellis A. Fundamentals of Chinese Medicine. Brookline, MA: Paradigm; 1996: 69.
About the Author
Joseph Alban is a Licensed Acupuncturist and Board Certified Herbalist known for his unique fusion of Chinese Medicine and Western Physiology. He specializes in the treatment of chronic pain, pelvic pain, and skin conditions. Joseph has a thriving practice at Alban Acupuncture and Herbs in New York City for ten years. He is passionate about making acupuncture accessible and helping people by treating their challenges at the root of the problem in a holistic and sustainable way. For more information, please call 212-319-5757 or go to www.AlbanAcupuncture.com