We report a case of overactive type neurogenic bladder with detrusor sphincter dyssnergia (DSD) that was successfully treated with acupuncture. The patient had urinary dysfunction after laminectomy of Th11, Th12 and L1. The symptoms chart, the frequency volume chart and urodynamic study (UDS) were used to evaluate urinary disturbance and the effect of acupuncture treatment. After the treatment, those charts showed improvement of pollakisuria, urinary urgency, urge incontinence, sense of residual urine and voiding volume. The UDS showed increase of bladder capacity, decrease of residual urine volume and disappearance of DSD. These results suggest that acupuncture treatment for overactive bladder and DSD is therefore useful. However, it is considered that the treatment for neurogenic bladder patients should be required long-term examination because of the importance for long-dated clinical observation.

This study investigated the population prevalence of chronic arterial occlusion (CAO) using the ankle pressure index (API) of patients with lower back pain in an acupuncture clinic. The API was measured in 60 lumbago patients ≥ 50 years old at the Meiji College of Oriental Medicine Acupuncture Center. There were 19 patients (31.7%) with unilateral or bilateral API < 0.9, which was presumed to indicate CAO. Thirty-four patients had symptoms in the lower limbs, and 17 of 34 patients showed an API below 0.9. In all but 4 patients (13 of 17, or 76.5%), laterality of the lower API and the symptoms were noted. In conclusion, API measured noninvasively might be useful as a predictor of CAO in acupuncture clinics.

[Purpose] Electrical acupuncture at the pudendal nerve was employed to treat perineal discomfort in two patients with chronic pelvic pain syndrome (CPPS), and the effectiveness was evaluated using a visual analogue scale (VAS).
[Methods] The patients were 67 and 65 years of age, respectively, when they were referred to the Meiji College of Oriental Medicine because of ineffective medical management of CPPS. Acupuncture at the BL-33 (Zhongliao) point and electrical acupuncture at the pudendal nerve were applied to treat symptoms of CPPS. Pain, discomfort, lower urinary tract symptoms and quality of life were evaluated using the National Institutes of Health Chronic Prostatitis Symptom Index, the International Prostate Symptom Score and a Visual Analogue Scale.
[Results] Acupuncture at BL-33 was not effective in improving the perineal discomfort of CPPS. However, the symptom was improved dramatically after electrical acupuncture to the pudendal nerve, and the effectiveness was demonstrated by VAS.
[Conclusions] Electrical acupuncture at the pudendal nerve may be effective in the treatment of pudendal discomfort due to CPPS. VAS was useful in evaluating improvements in pudendal discomfort.

[Objective]To evaluate the effectiveness of moxibustion treatment for patients with nocturia in a randomized controlled trial.
[Methods]Subjects were 36 patients with refractory nocturia, randomly allocated to a moxibustion group (n = 20) and a sham moxibustion group (n = 16). Moxibustion treatment to Chung-Chi (CV3) was performed three times/day for one week by the patients themselves. The average number of nocturia in the week before and the week during moxibustion treatment were compared between groups.
[Results]The average number of nocturia during moxibustion was significantly decreased in the moxibustion group compared to that before treatment. No significant change was seen in the sham moxibustion group.
[Conclusion]Moxibustion treatment appears to reduce the average number of nocturia. Moxibustion to Chung-Chi seems to represent an effective therapeutic option for nocturia.

A male patient aged 70 years, diagnosed as the benign prostatic hypertrophy (BPH) stage I, was the subject of this study. The effectiveness of acupuncture was evaluated by uroflowmetry (UFM). The patient received acupuncture treatments once a week for 5 weeks. Disposable needles (0.30mm in diameter), were inserted into bilateral Zhongliao (BL-33) points and rotated manually for 10 minutes. Average flow rate (AFR), maximum flow rate (MFR) and flow curve (FC) were used to evaluate the effectiveness of acupuncture treatment. The AFR before acupuncture, immediately after the treatments and twelve months after the cessation of acupuncture were 3.2ml/s, 11.4ml/s and 2ml/s, respectively. The MFR were 10ml/s, 20ml/s and 10ml/s, respectively. FC was observed as normal pattern during the treatment, but the obstructive pattern were recorded before and after the treatment.
Acupuncture treatment to the BL-33 points for BPH was shown to be useful although the effect was not long-lasting.

We studied the effect of acupuncture on a case of neurogenic impotence caused by surgery for ano-rectal cancer. Acupuncture needles (length: 60mm, diameter: 0.3mm) were inserted into bilateral Zhongliao (BL33) and were stimulated erectrically or rotated manually for 10 minutes. The effectiveness of acupuncture was evaluated by IMP DIARY, which was consisted of the rate of increase on Erectometer, and the changes of the subjective symptoms. We also investigated the effects of acupuncture stimulation on microcirculation of the glans penis. After the treatmeent, IMP DIARY showed improvement of nocturnal penile tumescence, morning erection and erection by masturbation. The microcirculation at the glans penis was increased significantly immediately after acupuncture therapy. From these results, acupuncture treatment to the BL-33 points for neurogenic impotence after surgery for ano-rectal cancer was considered to be useful.

[Objective]To evaluate the effects of acupuncture treatment for refractory urinary urgency and incontinence after radical prostatectomy.
[Methods]Three patients who had urinary urgency and/or urinary incontinence four months after radical prostatectomy received acupuncture at the BL33(Zhongliao) point. Acupuncture was performed once per week for four weeks. Symptoms were assessed by the International Prostate Symptom Score, IPSS QOL index for subjective evaluation and Frequency-Volume chart for objective evaluation.
[Results]After acupuncture treatment, urinary urgency and urge incontinence were improved, however stress urinary incontinence persisted. The scores for IPSS and IPSS QOL index were improved. Frequency-Volume charts showed that voided volume was increased and frequency of urination decreased after acupuncture treatment.
[Conclusions]Acupuncture at the BL33point might be a useful treatment option for urinary urgency and urge incontinence after radical prostatectomy.

This study examined the effectiveness of a communication program in undergraduate medical education in improving communication in physicians' clinical practice. The effectiveness of the program was assessed with a mail survey using self-rated questionnaires 9 years later. Ninety participants were follwed up in late 1994; 57.8% of them replied to the questionnaire. Of the respondents, 60% replied that programs concerned with active listening and role-playing had benefits on communicating with patients and families. In addition, 40% of respondents answered that case studies aimed at teaching comprehensive medicine with the team approach was effective in improving communication with co-medical staff. These results suggest that the communication program in undergraduate medical education is effective in improving clinical communication in clinical practice when students are highly motivated.

The frequencies of the urinary complaints oa the outpatients (male 188, female 339, average age 59.2+14.9) of the five acupuncture clinics were surveyed. The elder patients showed the higher frequencies of the urinary complaints. The frequencies of the complaints were as follows: nocturia (25.8%), urinary urgency (17.7%), stress incontinence (16.3%), sense of residual urine (15.2%), protracted micturition (12.0%), and retarded micturition (11.3%), respectively. The nocturia was accompanied with the majority of the other urinary complaints. These results suggest that the survey of the patient's complaint of nocturia is useful.