Urinary Retentionaccording to TCM

What is Urinary Retention?

Urinary retention is a condition characterized by the inability to empty the bladder completely. It can manifest as difficulty initiating urination, a weak urinary stream, or a sense that the bladder is not fully empty. Acute urinary retention is a sudden and painful inability to urinate, often requiring immediate medical attention.

How does TCM View Urinary Retention?

In Traditional Chinese Medicine, a 'pattern' refers to a complex of symptoms and signs reflecting an imbalance or blockage in the body's natural flow of Qi and Blood. Determining the specific pattern is pivotal as it guides the personalized treatment plan.

For urinary retention, identifying whether the cause is an Excess pattern like Damp-Heat causing obstruction, or a Deficiency pattern like Yin Collapse is essential. Proper pattern differentiation ensures that the treatment will harmonize and rebalance the body's energies, addressing both the symptoms and their underlying cause.

Root Causes of Urinary Retention in TCM

In TCM, urinary retention can arise from multiple sources. A common cause is Damp-Heat in the Lower Burner, which creates a blockage and inflammation in the urinary passages.

Another cause might be Yin Collapse, where there's a deficiency of cooling, nourishing fluids in the body, leading to symptoms like low-grade fever and restlessness alongside urinary issues. In addressing these imbalances, TCM seeks to identify the root cause based on a patient's unique presentation of symptoms and constitution.

Explore below more details about what might cause Urinary retention according to TCM.

  • By Syndrome
  • By Organ
  • Bladder
Detailed description of the cause

Yin Collapse

Yin Collapse in TCM represents an extreme form of Yin deficiency and is considered a serious and critical state of imbalance. It occurs when the body's nourishing and cooling Yin energy is so depleted that it can no longer counterbalance the active and warm Yang energy. This leads to a surge of uncontrolled Yang, manifesting as severe heat signs. The symptoms of Yin Collapse are more intense than those of a simple Yin deficiency. They include profuse sweating (especially at night), a severe sensation of heat and burning, often in the palms, soles, and chest, a very red tongue with little or no coating, a rapid and thin pulse, and potentially severe restlessness or agitation. There might also be symptoms of severe dryness, like dry throat, thirst, and dry skin. Yin Collapse is considered an emergency in TCM and requires immediate intervention. Treatment aims to rapidly nourish and replenish Yin while simultaneously subduing the excessive Yang.... see more

Yin Collapse Patterns That Can Lead to Urinary Retention

Pattern Name Relevant Symptoms Relevant Formulas
Collapse of Yin Urinary retention, Low grade fever, Night sweats, Restlessness, Dry mouth with desire to sip liquids, Heat sensation in palms, Flushed cheekbones, Emaciation, Constipation... see more Da Bu Yin Wan
Detailed description of the cause

Dampness

"Dampness" in TCM is a concept that describes a pattern of disharmony where the body accumulates excess moisture. Imagine the heavy, sticky feeling you get on a very humid day; that's similar to what dampness feels like internally. It can manifest as a sense of heaviness, bloating, sluggishness, or even a foggy mind. This condition is often thought to arise from environmental factors like living in a damp place, dietary habits that promote moisture in the body, or internal imbalances that hinder the body's ability to process fluids properly. In TCM, dampness can obstruct the normal flow of energy and fluids in the body, leading to various symptoms.... see more

Dampness Patterns That Can Lead to Urinary Retention

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Lower Burner Urinary retention, Scanty and yellow urine, Lower back pain, Weakness of lower extremities, Red and swollen feet, Swollen knee, Thick greasy vaginal secretions, Ulcers on the lower limbs, Scanty and dark urine, Painful urination, Dry mouth... see more Ba Zheng San
Detailed description of the cause

Heat

In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more

Heat Patterns That Can Lead to Urinary Retention

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Lower Burner Urinary retention, Scanty and yellow urine, Lower back pain, Weakness of lower extremities, Red and swollen feet, Swollen knee, Thick greasy vaginal secretions, Ulcers on the lower limbs, Scanty and dark urine, Painful urination, Dry mouth... see more Ba Zheng San
Detailed description of the cause

Wind

In TCM "Wind" is a concept that represents a pattern of disharmony, often characterized by its sudden and unpredictable nature, much like a gusty wind changing direction without warning. This pattern is associated with symptoms that come and go quickly or move around the body, such as itching, tremors, or even certain types of pain. Wind is considered to be a primary cause of illnesses that have these rapidly changing characteristics. In TCM, external Wind often refers to illnesses that start suddenly, like the common cold, believed to be caused by external pathogenic factors like climatic changes. On the other hand, internal Wind can be linked to internal imbalances and can manifest in conditions like dizziness or spasms. ... see more

Wind Patterns That Can Lead to Urinary Retention

Pattern Name Relevant Symptoms Relevant Formulas
Greater Yang Accumulation of Water Urinary retention, Aversion to cold, Fever, Slight thirst, Vomiting after eating Wu Ling San
Detailed description of the cause

Bladder

In TCM the Bladder plays a crucial role beyond its basic function of storing and excreting urine. It is intimately connected with the Kidney system, helping to regulate the body's water balance and being a key component in the processing and elimination of fluids. The Bladder also influences the lower part of the body and the back. When it malfunctions or is imbalanced in TCM, it can lead to urinary issues like frequent urination, incontinence, or painful urination. Additionally, there may be problems related to its meridian pathway, such as lower back pain, stiffness, or weakness in the legs. The Bladder’s condition in TCM can also reflect emotional states, with imbalances potentially leading to feelings of fear or anxiety.... see more

Bladder Patterns That Can Lead to Urinary Retention

Pattern Name Relevant Symptoms Relevant Formulas
Greater Yang Accumulation of Water Urinary retention, Aversion to cold, Fever, Slight thirst, Vomiting after eating Wu Ling San

TCM Herbal Formulas for Urinary Retention

Addressing urinary retention in TCM involves formulas that either expel Damp-Heat or nourish Yin. For Damp-Heat in the Lower Burner, Ba Zheng San, a formula with Chinese Pink Herbs (Qu Mai), is frequently used to clear Heat, promote diuresis, and alleviate symptoms.

For a Yin Collapse scenario, Da Bu Yin Wan, with Prepared rehmannia (Shu Di huang), helps to replenish the body's Yin and promote fluid production, thus aiding urinary function.

Explore below some TCM herbal formulas used to address urinary retention, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Formulas that clear heat and expel dampness
  • Formulas that nourish yin and tonify
  • Formulas that promote urination and leach out dampness
  • Formulas that warm the meridians and disperse cold
  • Formulas that warm yang and tonify
  • Formulas that expel dampness
  • Formulas that invigorate blood and dispel blood stagnation

Acupoints for Urinary Retention

Acupuncture points are selected based on their ability to influence the Qi dynamics of the urinary system. Points like Baohuang BL-53 and Pangguangshu BL-28 on the Bladder Channel are used to regulate Qi in the Lower Burner and to benefit urination.

Points on the Kidney Channel, such as Fuliu KID-7, open water passages and strengthen Kidney Qi. Meanwhile, Sanyinjiao SP-6 on the Spleen Channel supports the Spleen's role in fluid management and removes obstructions that can lead to retention. These points are part of a comprehensive treatment strategy tailored to the individual's specific TCM pattern of disharmony.

Explore below some acupoints used to address urinary retention, organized by meridian.

  • By Meridian
  • Bladder Channel
  • Liver Channel
  • Kidney Channel
  • Directing Vessel
  • Spleen Channel
  • Governing Vessel
  • Stomach Channel
  • Lung Channel
  • Triple Burner Channel
Sanjiaoshu BL-22

Sanjiaoshu BL-22

1.5 cun lateral to the lower border of the spinous process of the 1st lumbar vertebra.

Xiaochangshu BL-27

Xiaochangshu BL-27

At the level of the 1st posterior sacral foramen, 1.5 cun lateral to the posterior midline.

Pangguangshu BL-28

Pangguangshu BL-28

At the level of the 2nd posterior sacral foramen, 1.5 cun lateral to the posterior midline, in the depression between the medial border of the posterior superior iliac spine (PSIS) and the sacrum.

Ciliao BL-32

Ciliao BL-32

In the 2nd posterior sacral foramen, about midway between the posterior superior iliac spine (PSIS) and the midline.

Zhongliao BL-33

Zhongliao BL-33

In the 3rd posterior sacral foramen, between the posterior superior iliac spine and the midline.

Weiyang BL-39

Weiyang BL-39

At the lateral end of the popliteal crease, on the medial border of the tendon of biceps femoris muscle, 1 cun lateral to Weizhong BL-40 which is the midpoint of the popliteal crease. It is also 1 cun below Fuxi BL-38.

Baohuang BL-53

Baohuang BL-53

At the level of the 2nd posterior sacral foramen, 3 cun lateral to the posterior midline.

Zhibian BL-54

Zhibian BL-54

At the level of the 4th posterior sacral foramen, 3 cun lateral to the posterior midline.

Dadun LIV-1

Dadun LIV-1

On the lateral side of the dorsum of the great toe terminal phalanx, between the lateral corner of the nail and interphalangeal joint.

Xingjian LIV-2

Xingjian LIV-2

Between the first and second toe, on the dorsum of the foot, 0.5 cun proximal to the interdigital fold.

Taichong LIV-3

Taichong LIV-3

On the dorsum of the foot, between the 1st and 2nd metatarsal bones, in the depression proximal to the metatarsophalangeal joints and the proximal angle between the two bones.

Zhongfeng LIV-4

Zhongfeng LIV-4

1 cun anterior to the tip of medial malleolus, in the depression on the medial side of the tendon of the tibialis anterior.

Ligou LIV-5

Ligou LIV-5

5 cun above the tip of the medial malleolus, on the medial aspect and posterior to the medial crest of the tibia.

Ququan LIV-8

Ququan LIV-8

On the medial aspect of the knee join. Flex the knee and locate the point above the medial end of the popliteal crease, posterior to the medial condyle of the tibia, on the anterior border of the insertion of semimembranosus and semitendinosus muscle, about 1 cun anterior to Yingu KID-10.

Yinbao LIV-9

Yinbao LIV-9

4 cun above the medial epicondyle of the femur, between vastus medialis and sartorius muscle.

Zuwuli LIV-10

Zuwuli LIV-10

3 cun inferior to Qichong ST-30 which is on the upper border of the symphysis and 2 cun lateral to the anterior midline. The point is also on the lateral border of adductor longus muscle.

Yongquan KID-1

Yongquan KID-1

In the depression between the 2nd and 3rd metatarsal bones on the sole when the foot is in plantar flexion, approximately at the junction of the anterior and middle third of the sole.

Dazhong KID-4

Dazhong KID-4

Posterior and inferior to the medial malleolus, in the depression medial to the Achilles tendon, superior to its insertion at the calcaneus.

Fuliu KID-7

Fuliu KID-7

2 cun directly above Taixi KID-3, on the anterior border of Achilles tendon.

Jiaoxin KID-8

Jiaoxin KID-8

2 cun above Taixi KID-3, 0.5 cun anterior to Fuliu KID-7, posterior to the medial border of tibia.

Henggu KID-11

Henggu KID-11

5 cun below the umbilicus, on the upper border of symphysis pubis, 0.5 cun lateral to the anterior midline. It is at the same level as Qugu REN-2 which is at the anterior midline.

Qugu REN-2

Qugu REN-2

On the midline of abdomen, just on the upper border of the symphysis pubis.

Zhongji REN-3

Zhongji REN-3

On the anterior midline, 4 cun below the umbilicus, 1 cun above Qugu REN-2, which is located at the upper border of the symphysis pubis.

Guanyuan REN-4

Guanyuan REN-4

On the midline of the abdomen, 3 cun below the umbilicus.

Shimen REN-5

Shimen REN-5

On the midline of the abdomen, 2 cun below the umbilicus.

Yinjiao REN-7

Yinjiao REN-7

On the midline of the abdomen, 1 cun below the umbilicus.

Sanyinjiao SP-6

Sanyinjiao SP-6

3 cun directly above the tip of the medial malleolus, on the posterior border of the tibia, on the line drawn from the medial malleolus to Yinlingquan SP-9.

Yinlingquan SP-9

Yinlingquan SP-9

On the lower border of the medial condyle of the tibia, in the depression between the posterior border of the tibia and gastrocnemius muscle.

Jimen SP-11

Jimen SP-11

6 cun above Xuehai SP-10, on the line draw from Xuehai SP-10 to Chongmen SP-12.

Chongmen SP-12

Chongmen SP-12

Lateral to the inguinal groove, on the immediate lateral side of the femoral artery, at the level of the upper border of symphysis pubis, 3.5 cun lateral to Qugu REN-2.

Changqiang Du-1

Changqiang Du-1

Midway between the tip of the coccyx and the anus.

Mingmen DU-4

Mingmen DU-4

On the lower back midline, in the depression below the spinous process of the 2nd lumber vertebra (L2).

Baihui DU-20

Baihui DU-20

At the vertex, at the junction of a line connecting the apex of the ears and the midline, in the depression 7 cun above the posterior hairline and 5 cun behind the anterior hairline.

Daju ST-27

Daju ST-27

2 cun below the umbilicus, 2 cun lateral to the anterior midline.

Shuidao ST-28

Shuidao ST-28

3 cun below the umbilicus, 2 cun lateral to anterior midline.

Zusanli ST-36

Zusanli ST-36

3 cun below Dubi ST-35, one finger breadth lateral to the anterior crest of the tibia, on the tibialis anterior muscle.

Chize LU-5

Chize LU-5

On the cubital crease, on the redial aspect of the biceps tendon. It can be easily identified when the elbow is slightly flexed.

Yangchi TB-4

Yangchi TB-4

At the junction of the ulna carpal bones of the wrist dorsum, in the depression lateral to the tendon of extensor digitorum and extensor digiti minimi muscle.