Observation Of The Clinical Efficacy Of The Electro-acupuncture Treatment Of Cauda Equina Injury Urinary Retention

Objective:we report on the therapeutic effectiveness and feasibility of sacral neuromodulation with electroacupuncture in patients with urinary retention which is caused by cauda equina injury and refractory to conventional conservative therapies.Methods:From Jan 3rd,2006 to September 20th,2009, we prospectively evaluated twenty-one patients with neurogenic urinary retention of cauda equina injury that underwent electroacupuncture at points of bilateral BL 32, BL 33 and BL35 for consecutive more than two sessions. Voiding ability, amount of post-voiding residual urine and maximum urinary flow rate were documented as major evaluating items for voiding behaviors and we compared these items before and after treatment.Results:43%(9/21 cases) of the total enrolled patients resumed their self-voiding ability and were catheter free.the mean post-voiding residual urine volume for these twenty-one patients decreased from 265.4±109.4ml at baseline to 74.7±53.1ml with a clinical improvement rate of 71.86%(p=0.0000). The maximum urinary flow rate increased from3.7±2.9ml/s to 15.7±8.1ml/s with a clinical improvement rate of 75.0%(p=0.0078). All 21 patients regained their bladder-filling sensation. Scores of difficulties in voiding dropped from 6.8±2.1 Scores at baseline to 4.4±2.2 Scores (10 Scores indicate extremely difficulty in voiding) with a mean improvement rate of 36.0%(p=0.0001).Conclusion:Our study showed that electroacupuncture significantly improved the voiding ability and functions of patients with neurogenic urinary retention and it implied that bilateral sacral neuromodulation with electroacupuncture might be effective and feasible in the management of neurogenic urinary retention of cauda equina injury. Compared with conventional sacral neuromodulation, electroacupuncture at the sacral region could offer an easily manageable, intermittent neuromodulation for patients with neurogenic urinary retention with no or only a few side effects. Furthermore, this technique is easy to implement, with less financial costs and better safety.