Retention of Urine During Pregnancy

CHAPTER 41 Retention of Urine During Pregnancy



AETIOLOGY 533

PATHOLOGY 533

IDENTIFICATION OF PATTERNS AND TREATMENT 534
Spleen-Qi deficient and sinking 534

Kidney-Qi deficient and sinking 535

Damp-Heat in the Bladder 536

PROGNOSIS AND PREVENTION 537

This condition is characterized by difficult urination, slight retention of urine, an uncomfortable feeling in the lower abdomen and a feeling of irritability.



Aetiology




Excessive physical exercise


Excessive physical exercise injures the muscles and the Spleen and may lead to Spleen-Qi deficiency. When Spleen-Qi is deficient, it may also sink leading to a slight prolapse of the internal organs. In pregnancy, this is aggravated by the pressure of the growing fetus on the bladder which, together with Spleen-Qi deficiency, may lead to a slight retention of urine.


The Medical Collection of Four Families from Meng He says:



Urinary problems in pregnancy are due to the fetus weighing down, pressing on the bladder, leading to urinary problems (which could be retention or incontinence). To treat it, one must raise Qi and lift the fetus.1



Excessive sexual activity, excessive standing or lifting


Excessive sexual activity during the last trimester of pregnancy or excessive lifting and standing may injure the Kidneys and lead to the sinking of Kidney-Qi. In pregnancy, the pressure of the growing fetus on the bladder, together with the sinking of Kidney-Qi, may cause retention of urine.



External Dampness


External Dampness may invade the channels of the legs: in women, it easily settles in the urinary passages. Here, Dampness obstructs the transformation and transportation of urine and may cause retention.



Irregular diet


Excessive consumption of dairy foods and greasy foods easily leads to Dampness. This often settles in the urinary passages and obstructs them in the same way as described above.



Pathology


The pathology of retention of urine in pregnancy is characterized by a combination of interacting physical and energetic components. The sinking of Spleen-Qi and/or Kidney-Qi may lead to the fetus dropping down slightly and pressing on the bladder; vice versa, the downward pressure of the growing fetus may lead to the sinking of Spleen- and/or Kidney-Qi. Although normally retention of urine may be due to either Full or Empty causes, in pregnancy it is always due to Empty causes; these may be deficiency and sinking of Spleen-Qi or Kidney-Qi. Thus, the treatment consists in tonifying and raising Spleen- or Kidney-Qi and stimulating the Bladder’s function of Qi transformation.



Identification of patterns and treatment


The patterns discussed are:


• Spleen-Qi deficient and sinking

• Kidney-Qi deficient and sinking

• Damp-Heat in the Bladder.


Spleen-Qi deficient and sinking



Clinical manifestations


Frequent but scanty urination, discomfort in the lower abdomen, a bearing-down sensation, restlessness with inability to sit or lie down, pale complexion, tiredness, shortness of breath. Tongue: Pale. Pulse: Weak.



Treatment principle


Tonify Spleen-Qi, raise Yang, lift the fetus.



Acupuncture


BL-20 Pishu, Du-20 Baihui, ST-36 Zusanli, BL-28 Pangguangshu. All with reinforcing method.




Explanation


– BL-20 tonifies Spleen-Qi.

– Du-20 and ST-36 tonify and raise Qi.

– BL-28 tonifies the Bladder and its function of Qi transformation.


Herbal treatment



a Prescription



– YI QI DAO NI TANG

– Benefiting Qi and Conducting Turbidity Decoction


Explanation


– Dang Shen, Bai Zhu, Bian Dou and Fu Ling tonify and raise Spleen-Qi.

– Sheng Ma and Jie Geng, in combination with Qi tonics, raise Qi.

– Wu Yao, Gui Zhi and Tong Cao move Qi in the hypogastrium, warm the Bladder and promote the transformation of Water. Tong Cao should be used with caution in pregnancy and it should therefore be used in a very small dose.


b Prescription



– YI QI LI SHUI TANG

– Benefiting Qi and Transforming Water Decoction


Explanation


– Huang Qi, Dang Shen and Bai Zhu tonify and raise Qi.

– Sheng Ma, in combination with Huang Qi, raises Qi.

– Tong Cao opens the Water passages and removes obstructions from the Connecting channels.

– Gui Zhi, in combination with Tong Cao, opens the Water passages by tonifying the Minister Fire and warming the channels; Heat is necessary to transform Water.

– Che Qian Cao and Ze Xie drain Dampness from the Lower Burner.

– Yi Mu Cao and Dang Gui invigorate and nourish Blood.

– Wu Yao moves Qi, which helps to open the Water passages in the Lower Burner.

– Gu Ya promotes digestion.

Related posts:

  1. Vaginal Itching (and Trichomonas and Candida Infections and Genital Eczema)
  2. Prolapse of the Uterus
  3. Acupuncture and Herbal Treatment in Midwifery
  4. Endometriosis

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Retention of Urine During Pregnancy

Full access? Get Clinical Tree
Get Clinical Tree app for offline access