Difficulty urinating
During difficult urination, it takes a lot of effort to empty the bladder. For example, it may be difficult to activate the urinary stream, the radius may be weak or interrupted or you may need to push in order to urinate. Sometimes the feeling that the bladder is not completely empty remains after passing urine.
There are many possible causes. In men, for example, an enlarged prostate may interfere with the flow of urine, but also urinary tract infection, kidney or bladder stones, narrowing of the urethra, certain medications or neurological disorders can cause problems.
Within Chinese medicine a distinction is made between different patterns that can contribute to reduced urine flow. Acupuncture and Chinese herbal medicine can be used in addition depending on the cause and the grievance image.
Possible Western disorders
Difficult to urinate is a symptom and not a condition in itself. Possible causes include:
- an enlarged prostate (benign prostatic hyperplasia);
- urinary tract infections;
- prostatitis;
- Renal, urinary or bladder stones;
- narrowing or scarring of the urethra;
- problems with the functioning of the bladder muscle or sphincter;
- sagging of the bladder or uterus;
- severe constipation in which the intestine exerts pressure on the urinary tract;
- neurological disorders affecting bladder control;
- certain medicines, including medicinal products with anticholinergic action.
Physical obstruction of the urinary tract should also be excluded, and medical assessment is therefore important in case of new, obvious or increasing problems with urination.
Possible causes
The cause depends, among other things, on age, gender and additional complaints.
In men, a weaker urinary stream at an older age is often caused by an enlarged prostate. An infection or inflammation can cause swelling and irritation, which makes it more difficult to urinate. Stones can hinder the urine flow and often cause pain.
Sometimes there is no obvious mechanical blockage, but the bladder and sphincter do not work well together. Also disorders of the nervous system can interfere with the control of the bladder.
In women, changes around the menopause and a sagging can contribute to problems with urination.
How can acupuncture help with difficulty urinating?
The treatment is tailored to the cause of the symptoms and the underlying TCM-pattern. For example, it looks at the strength of the urinary stream, how much urine is produced, or presses are needed and whether there is pain, heat, cold, fluid build-up, stress or fatigue.
Depending on the grievance picture, acupuncture can be aimed at:
- support the function of the Bladder within TCM;
- Improve Qi flow in the lower abdomen;
- Dampness and Heat reduce when signs of irritation or inflammation are present;
- Increase Spleen-Qi when fatigue and weak fluid balance are at the forefront;
- Support kidney-Yin or kidney-Yang in long-term deficiency patterns;
- improve Qi and Blood flow when stagnation is involved.
When the urine flow is obstructed by a physical obstruction, treatment of the underlying cause is important. Acupuncture does not replace this regular treatment.
How can Chinese herbal medicine help with difficulty urinating?
Chinese herbs are chosen just like acupuncture on the basis of the overall picture of complaints. Difficult urinating by Dampness-Heat, for example, requires a different treatment within TCM than a weak urinary stream associated with fatigue, cold and general weakness.
Depending on the pattern, herbal treatment may focus on:
- supporting urine discharge and fluid management;
- Reduce Dampness and Heat;
- support the free movement of Qi;
- Enhance Spleen-Qi;
- Heating and supporting kidney-Yang;
- Feed kidney-Yin;
- Reduce blood stagnation.
Herbs can be used daily between acupuncture treatments. In case of kidney problems, physical obstruction of the urinary tract or use of medicines, special attention is needed for regular diagnosis and treatment.
How does Chinese medicine view difficulty urinating?
Within Chinese medicine, good urine discharge depends on a combination of different bodily functions. Especially the Bladder, Kidney and Spleen play an important role in this.
The Bladder stores urine and ensures its final excretion within TCM. The Kidney supports the processes by which liquids are processed and excreted. The Spleen plays a role in the processing and displacement of moisture through the body.
The Liver can also be relevant. Within TCM, the Liver is involved in the free movement of Qi. For example, if this flow stagnates under pressure or stress, according to TCM it can also influence the function of the lower abdomen and Bladder.
Difficult urinating can result in roughly two ways. There may be a volte pattern, where for example Dampness Heat, Qi-stagnatie or Blood stasis hinders the normal urine flow. There may also be an deficiency patterns, where there is insufficient Qi or Yang to effectively separate the urine.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, the movement of Qi according to TCM is less free. This can also affect the abdomen and urinary discharge. Typical is that the symptoms can clearly change and often worsen during periods of stress or stress.
In women, this pattern can sometimes become clearer around menstrual periods.
Common symptoms
- difficulty starting to urinate;
- hesitant or interrupted urine flow;
- complaints made worse by stress or frustration;
- tension or a set-up sensation in the lower abdomen;
- irritability;
- sighing or feeling oppressive;
- tense abdomen or varying bowel movements;
- in women, possibly more menstrual complaints.
Examples of Western disorders
This pattern can be recognised, among other things, in the case of functional problems with urine, where tension of the pelvic floor or sphincter is involved and in stress-sensitive urinary tract complaints.
Dampness-Heat in the Bladder
Brief explanation
At Dampness-Heat, a combination of fluid accumulation and Heat, according to TCM, hinders the normal function of the Bladder. The amount of urine is often reduced and there are usually also signs of irritation or heat.
When pain and a burning sensation are at the forefront, the symptoms are more suitable for painful urination.
Common symptoms
- difficult and difficult urination;
- small amounts of concentrated urine;
- drip urine;
- feeling hot or burning when passing urine;
- pressure or discomfort in the abdomen;
- sometimes low back pain;
- bitter taste;
- nausea or decreased appetite;
- sometimes constipation.
Examples of Western disorders
This pattern can be found in cystitis, urethritis, prostatitis and other urinary tract infections.
Spleen-Qi-deficiency
Brief explanation
The Spleen supports both the movement of Qi and the processing of moisture within TCM. If Spleen-Qi has insufficient strength, the urine flow can become weak. The symptoms are usually longer and more often associated with fatigue and digestive problems.
More severe or prolonged weakness may also involve Spleen-Yang or Kidney-Yang.
Common symptoms
- difficulty in triggering the urine flow;
- weak or slow urinary stream;
- have to push to keep peeing;
- small amounts of urine;
- symptoms that are worse in case of fatigue;
- feeling heavy or depressed in the lower abdomen;
- fatigue and listlessness;
- low appetite;
- bloated abdomen;
- loose stools;
- Sometimes stick to fluid.
Examples of Western disorders
Such a pattern can be found in long-term functional puddle problems and in some complaints where the bladder is not adequately emptied.
Kidney-Yang-deficiency
Brief explanation
Within TCM, kidney-Yang represents the warming and activating force behind moisture processing and urine discharge. If this function weakens, there may be insufficient power to empty the bladder properly.
Common symptoms
- difficulty starting to urinate;
- weak or interrupted urinary stream;
- feeling that the bladder is not completely empty;
- sometimes frequent urge but difficulty in secreting urine;
- must press;
- Curvature;
- cold hands and feet;
- fatigue;
- cold or weak lower back and knees;
- retention of fluid, especially in the lower body;
- loose stools sometimes.
Examples of Western disorders
This pattern can be found, among other things, in the case of prolonged problems with water, including symptoms of enlarged prostate and some types of decreased bladder function.
Kidney-Yin-deficiency
Brief explanation
According to TCM, kidney-yin deficiency reduces the nourishing and cooling aspects of the kidney system, which can cause dryness and relative heat. Urine is usually limited and concentrated and symptoms are more often associated with signs of dryness and heat.
Common symptoms
- difficulty in triggering the urine flow;
- small amounts of concentrated urine;
- increased pressure and low urine levels;
- dry mouth and throat;
- heat from palms and soles of the feet;
- night sweats;
- restlessness or poor sleep;
- dizziness or ringing in the ears;
- weakness or lower back and knee pain;
- dry stools or constipation.
Examples of Western disorders
This pattern may occur for chronic urinary problems and for urinary problems around and after the menopause.
Blood stasis
Brief explanation
Blood stasis means that local blood flow is disturbed within TCM. In difficult urination, this is mainly considered when the symptoms are prolonged and there are clear signs of obstruction, fixed pain or blood in the urine.
A mechanical obstruction should always be investigated regularly in the event of such complaints.
Common symptoms
- hesitant or interrupted urine flow;
- thin or weak radius;
- effort to completely empty the bladder;
- local stabbing pain in the abdomen;
- pain that may be worse under pressure;
- sometimes blood or blood clots in urine;
- dark or purple discoloration of the tongue.
Examples of Western disorders
Such a sign of symptoms may include kidney or bladder stones, chronic prostatitis, narrowing of the urethra and other urinary tract conditions that impede the flow of urine. The TCM pattern does not explain the physical obstruction, which should be examined and treated separately.
When to contact your doctor?
New or increasing problems with urination deserve medical assessment, especially when it is not clear what caused them.
If you can't urinate at all or almost no longer while the bladder feels full, rapid medical assessment is necessary. Acute urinary retention may cause damage to the bladder and kidneys and may require treatment with a catheter.
Please also contact your doctor at:
- blood in urine;
- fever, chills or clearly ill;
- severe pain in the abdomen, her or back;
- sudden strongly decreased urine production;
- an ever weaker or interrupted urinary stream;
- regular feeling that the bladder is not emptying;
- recurrent urinary tract infections;
- new problems with urine in combination with neurological symptoms.
These symptoms may require examination of the urine, bladder, prostate, kidneys or urinary tract.
Outlook
The course of treatment depends heavily on the cause. Functional problems with urine without physical obstruction may react differently than symptoms due to, for example, an enlarged prostate, stones, a narrowing of the urethra or a neurological condition.
In case of complaints where tension and Qi-stagnation clearly play a role, changes can sometimes occur relatively quickly. Empty patterns of Spleen or Kidney usually develop gradually and usually require more time. When a structural obstruction is present, the prognosis is mainly determined by the underlying condition and its regular treatment.
In the initial phase, one acupuncture treatment per week is a common guideline. In complaints where acupuncture treatment is appropriate, depending on severity and situation may be treated temporarily more frequently. If the symptoms become less stable, the frequency can be reduced. Chinese herbs can be used daily between treatments where appropriate.
Contact
Do you have trouble urinating regularly and want to know if acupuncture and/or Chinese herbal medicine can fit in with your symptoms? During a first consultation we discuss how you pee and other relevant symptoms and symptoms. Based on the overall picture of complaints, we will examine which TCM pattern is probably at the forefront and what treatment fits in with it.
In case of new, obvious or increasing problems with urination it is important to have regular examination of the cause.