The Effect of Transcutaneous Electrical Acupoint Stimulation on Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Transurethral Resection of the Prostate

Abstract

Background. Catheter-related bladder discomfort (CRBD), an extremely distressing complication secondary to an indwelling urinary catheterization, is frequently reported in patients with transurethral resection of the prostate (TURP), postoperatively. A prospective, randomized, controlled, double-blind study was designed to assess the efficacy of transcutaneous electrical acupoint stimulation (TEAS) as a treatment for CRBD in patients undergoing TURP. Methods. Seventy benign prostatic hyperplasia male patients undergoing TURP under general anesthesia requiring intraoperative urinary catheterization were enrolled for the trial. An experienced acupuncturist performed TEAS for 30 minutes before general anesthesia with acupoints RN7, RN6, RN5, RN4, and RN3 and bilateral BL32, BL33, and BL34. Mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO2), body temperature (T), and blood samples were collected during the surgery. A series of assessments included the incidence and severity of CRBD, postoperative pain, nausea and vomiting, and physical and mental state measurements. Results. The incidence of CRBD was significantly lower in TEAS group than in control group at the time T5 [9(26%) vs. 28(80%), P < 0.001 ], T9 [20(57%) vs. 28(80%), P = 0.039 ], T11 [7(20%) vs. 31(89%), P < 0.001 ], and T12 [4(11%) vs. 7(20%), P = 0.003 ]. The severity of CRBD was significantly lower in TEAS group than in control group at the time T5 [0 vs. 10 (29%), P < 0.001 ], T9 [2(6%) vs. 10(29%), P = 0.011 ], and T11 [0 vs .9(26%), P = 0.002 ]. The QoR-40 total score was higher in TEAS group at time T11 [191.7(4.4) vs. 189.1(4.3), P = 0.007 ] and T12 [195.3(1.9) vs. 193.3(3.0), P < 0.001 ]. The postoperative analgesia requirement was higher in control group [5.0(2.9) vs. 3.8(1.9), P = 0.045 ]. Conclusions. TEAS could significantly prevent the incidence and severity of CRBD, reduce the postoperative analgesic requirement in the early postoperative period, and promote the quality of early recovery in patients undergoing TURP.

Effectiveness of systemic acupuncture in the control of urinary incontinence following radical prostatectomy: a randomized clinical trial

“…BL32 and BL33 belong to the Bladder meridian, and according to TCM this meridian and acupoints mainly treat diseases associated with the urinary system (12) . It is suggested that through these acupoints there is stimulation of the sacral nerves, detrusor, and pelvic muscles to regulate the function of the bladder, urethral sphincter and nerve innervation effector (12)(13)(14) . Stimulation of these acupoints increases the resistance of the urethra and pelvic floor muscles (14) making them essential for urinary continence.…”

“…To produce a protocol of points that could help other acupuncturists to treat not only the symptoms, but also the root cause of PRPUI, in addition to the points referred to as the most used (BL23, BL28, BL32, BL33, ST36, SP6) (12)(13)(14)29,30) , points BL13, BL15, BL18, BL20 and LV5 were used which, according to TCM, have effects on the possible causes of prostate cancer. It was noted that the use of these lumbosacral and leg region acupoints showed clinically significant benefits in reducing PRPUI.…”

Efetividade da acupuntura sistêmica no controle da incontinência urinária pós-prostatectomia radical: ensaio clínico randomizado

“…Essa ciência defende que todas as funções do corpo são reguladas para manter um equilíbrio de Qi, e o desvio, portanto, é descrito como doença. Qi é a energia vital que circula dentro do indivíduo, que mantém o funcionamento dos órgãos e, portanto, promove a manutenção da vida (5,12) . Assim, no caso de IU, o reequilíbrio deve ser feito nos meridianos que influenciam a continência urinária (5,12) .…”

“…Qi é a energia vital que circula dentro do indivíduo, que mantém o funcionamento dos órgãos e, portanto, promove a manutenção da vida (5,12) . Assim, no caso de IU, o reequilíbrio deve ser feito nos meridianos que influenciam a continência urinária (5,12) . Os pontos de acupuntura (acupontos), dispostos ao longo dos canais por onde circula o Qi (meridianos), são estimulados com a inserção de finas agulhas para equilibrar o Qi e, consequentemente, prevenir ou tratar a doença e seus sintomas (5) .…”

“…A acupuntura é um tipo de tecnologia de estimulação nervosa por meio de agulhas. No contexto da IU e da prática clínica, pode produzir estimulação tibial posterior e equilíbrio do nervo sacral, de modo a desempenhar um papel terapêutico que favorece a continência (12,13) . Segundo a MTC, a IU está associada à deficiência de Qi e Yang do Baço-Pâncreas e Rins, e consequente umidade que compromete a abertura e o fechamento uretral (14) .…”