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AcupuncturePhysicalMedicineStyle UrinaryDysfunction
Sources
1.Seem,Mark,AcupuncturePhysicalMedicine.BluePoppyPress,2000. 2.http://www.nlm.nih.gov/medlineplus/ency/article/003143.htm 3.http://www.mayoclinic.com/health/urinaryincontinence/DS00404 4.http://www.tsca.edu/site/research/Category:PracticeGuidelines/
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OverviewofCondition
Urinaryincontinence,thelossofbladdercontrol,isacommonandoftenembarrassingproblem. Theseverityofurinaryincontinencerangesfromoccasionallyleakingurinewhenyoucoughor sneezetohavinganurgetourinatethat'ssosuddenandstrongyoudon'tgettoatoiletintime. [2] Urinaryhesitancyaffectspeopleofallagesandoccursinbothsexes,butitismostcommonin oldermenwithenlargedprostateglands.Urinaryhesitancyusuallycomesongradually.It sometimesgoesunnoticeduntilurinaryretention(completeinabilitytourinate)produces distentionanddiscomfortinthebladder.[3]
PatternsofDisharmony
InAPMUrinaryDysfunctionfallsunderthepatternoffatigueknownasPelvicCollapse
ClinicalManifestations
Patientswillpresentwithahollowsensationorweaknessinthemusclesofthemiddle abdomenwithtightnessbelowthenavel.Inseverecasesthemusclesofboththemiddleand lowerheaterscandropdowncausingprolapseofinternalorgansincludingtheurinarybladder. [1Pp9192]
PalpatoryFindings
Patientswilloftenpresentwithtightnessintheshaoyangandyangmingzoneintherectus abdominusandthelowerexternalobliquesintheareaofGB26,GB27,andGB28.Onemay feelachopsticklikeconstriction1/2inchfromthemidlinefromthenaveltothepubicbone. FeelalsofortriggerpointsintherectusfromthelevelofST25toST30[1Pp92,113]
TreatmentPrinciple
ReleaseconstrictionsintheYangMing/ShaoYangzonesandsupplementweaknessinthe
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ReleaseconstrictionsintheYangMing/ShaoYangzonesandsupplementweaknessinthe middleheater
TreatmentStratgey
Jing:InfinitytreatmentwithSP4(right)+PC6(left)forChongandGB41(left)+TH5(right)forDaiMai.Note thatthisisonepairofyinandonepairofyangextraordinaryvessels. Ying:BilateralKD3,LV3,andSP6.Lowerheaterregulatoryforthe3legyinareaddedCV2,CV3,and CV6.SupplementCV12andST36formiddleheaterdeficency.AddGV20forprolapseorgans Wei:TriggerPointsnearSP10orLV9inthevastusmedialisorsatoriusmuscletoreleasethepelvic area.Localtriggerpointsintheexternalobliquesandrectusabdominusmusclesintheareasof
GB26GB28andST25ST30.[1Pp92,114]
PatientEducation
Itisrecommendedthatpatientsdocrunchesorothercorestrengtheningexercisesto strengthenthemiddleheaterandreleaseconstrictionsinthelumbarregion.Deepabdominal breathinginthemorningandatnightisalsobeneficialforreleasingconstrictioninthemiddle andlowerheaters.Kegelexercisecanhelpstrengthenthepelvicfloormuscles.[1Pp114]
Prognosis
Thepatternofpelviccollapseisoftenduetoprolongedstress.Thisisachronicconditionsoit isrecomendedthatapatienthaveaninitialseriesof36visitsspacedonceadaytooncea week,dependingonthestyleofacupunctureandpatientsoverallhealthstatus,followedupby longerandlongerintervalsbetweentreatmentswhilethepatientcontinuestoimprove.Patients mightexpectasignificantreductioninfrequencyandintensityofpain,discomfort,dysfunction anddistress,andanoverallimprovementinqualityoflifeandgeneralwellbeing.Whenthe anticipatedimprovementhasbeenachieved,treatmentisdiscontinued.Manypatientsarethen abletoexperiencesustainedimprovementforseveralmonthsorlonger.Afollowuptreatment willbeadministerediftheconditionworsens,andpatient/clientstypicallyneedfarlessfrequent oroverallnumberoftreatmentswhentheyreturnforasecondepisodeofcare.[4]
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