Urinary incontinence after a stroke

Image by Gerd Altmann from Pixabay

The term Neurogenic Bladder refers to nerve dysfunction of the bladder. Symptoms can include urinary incontinence, urgency, frequency and overactive bladder. Causes of neurogenic bladder may be from diseases of the central nervous system like strokes, tumours, multiple sclerosis, Parkinson’s Disease, dementia or other neurodegenerative diseases. It may also be from damage to the peripheral or autonomic nervous system due to things like diabetes, vitamin B12 deficiency or nerve damage from surgery.

My patient was a 68 year old gentleman who had unfortunately gotten a neurogenic bladder after suffering a stroke after a prostatectomy (surgery to remove the prostate) for prostate cancer. I saw this gentleman 2 years after this event. The good news is that he remained prostate cancer free, but the bad news was that his neurogenic bladder was not any better. He had a significantly overactive bladder with a weakened pelvic floor muscles and urethral sphincters. The net result of this was that if he drank even a small amount of water, he would quickly have a strong urge to urinate and would have to rush to the toilet within 10 minutes otherwise he would wet himself. He would wear an adult nappy when outside the house. Along with pelvic floor exercises, he had tried several medications but with no success. He found himself preferring to stay at home rather than face the embarrassment of wetting himself in public.

He was kind enough to let me try an acupuncture point on him because at this stage nothing else was working. I applied laser acupuncture for half a second to a single point on the face (less is more!). This point is one that I believe connects the central nervous system up to the bladder. I told him that this was just a trial and if there were no changes within two weeks then I would consider it to be unsuccessful and no point treating further. To my pleasant surprise, he came back two weeks later elated. He could now hold his bladder for 30 minutes before need to rush off. I treated him for a total of 5 treatments, each two weeks apart. Each time the same point. The last I saw him, he could hold his bladder for 4 hours (which is pretty much normal function) and he no longer needed to use his adult nappy when outside. I offered further treatment, but he said he was extremely happy with how it was now and didn’t need any further treatment. He would only come back as he needed. Importantly, I advised him to continue his pelvic floor exercises indefinitely.

Over 10 weeks, this gentleman’s quality of life had dramatically improved and he was very grateful. I, in turn, was grateful to him for letting me try laser acupuncture on him.

There are several studies out there treating neurogenic bladder with needle acupuncture with some varying results. Most certainly it’s very commonly done in China. I believe the evidence for this is slowly building up but currently is not considered evidence based as of yet. Definitely I can say I have anecdotal evidence of amazing results for post-stroke neurogenic bladder using my particular acupuncture style. If you have this condition or you know someone with it, it’s worth at least having a try to see if acupuncture can help. If you haven’t had success with more traditional styles of acupuncture, then I’d love to see if I can make a difference with my particular style *.

* Just as there are different styles of martial arts, there are many styles of acupuncture each with their own strengths and weaknesses. Even within laser acupuncture itself there are different philosophies and styles!

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