Clinical Observation of Intermittent Catheterization Combined with Auricular Point Pressing Therapy for Neurogenic Bladder Following Spinal Cord Injury
Objective: To evaluate the clinical efficacy of intermittent catheterization combined with auricular seed pressure therapy in patients with neurogenic bladder (NB) secondary to spinal cord injury (SCI), and to provide evidence-based guidance for optimizing clinical management strategies. Methods: Seventy patients with NB following SCI who were treated at the Fifth Affiliated Hospital of Jinan University between January 2023 and June 2025 were enrolled in this study. Participants were randomly assigned to either the observation group or the control group using a random number table, with 35 patients in each group. The control group received standard intermittent catheterization alone, whereas the observation group received additional auricular seed pressure therapy in conjunction with the same catheterization regimen. Primary and secondary outcomes—including urinary function parameters, clinical symptom severity, bladder function indices, quality of life (QoL), and overall clinical response rate—were assessed before treatment and after the intervention period. Results: Following treatment, the observation group demonstrated significantly lower daily micturition frequency, fewer episodes of urinary incontinence, and a reduced incidence of urinary tract infections (UTIs), along with a higher average single voided volume compared to the control group (P = 0.021, P = 0.018, P = 0.039, P = 0.024; all P < 0.05). The observation group also exhibited lower symptom scores for dysuria, urethral discomfort/pain, and lower abdominal distension, as well as greater maximum bladder capacity and lower post-void residual urine volume (P = 0.017, P = 0.033, P = 0.029, P = 0.008, P = 0.014; all P < 0.05). Furthermore, improvements in psychological function, physical function, social function, and material well-being were significantly greater in the observation group than in the control group (P = 0.036, P = 0.023, P = 0.041, P = 0.039; all P < 0.05). The overall clinical response rate was significantly higher in the observation group compared to the control group (P = 0.047; P < 0.05). Conclusion: Intermittent catheterization combined with auricular seed pressure therapy significantly improves urinary and bladder function, alleviates clinical symptoms, and enhances overall quality of life in patients with neurogenic bladder secondary to spinal cord injury, demonstrating superior therapeutic efficacy.
References
[1]
He, S.B., Bao, J.S., Wu, G.J., et al. (2016) Two Cases of Neurogenic Bladder Caused by Intraspinal Teratoma in the Lumbar Region in Adults. Chinese Journal of Urology, 37, 840.
[2]
Nevedal, A., Kratz, A.L. and Tate, D.G. (2015) Women’s Experiences of Living with Neurogenic Bladder and Bowel after Spinal Cord Injury: Life Controlled by Bladder and Bowel. DisabilityandRehabilitation, 38, 573-581. https://doi.org/10.3109/09638288.2015.1049378
[3]
Shang, Z., Jia, C., Yan, H., Cui, B., Wu, J., Wang, Q., et al. (2018) Injecting RNA Interference Lentiviruses Targeting the Muscarinic 3 Receptor Gene into the Bladder Wall Inhibits Neurogenic Detrusor Overactivity in Rats with Spinal Cord Injury. NeurourologyandUrodynamics, 38, 615-624. https://doi.org/10.1002/nau.23894
[4]
Gomelsky, A., Lemack, G.E., Castano Botero, J.C., Lee, R.K., Myers, J.B., Granitsiotis, P., et al. (2018) Current and Future International Patterns of Care of Neurogenic Bladder after Spinal Cord Injury. WorldJournalofUrology, 36, 1613-1619. https://doi.org/10.1007/s00345-018-2277-8
[5]
Manack, A., Motsko, S.P., Haag‐Molkenteller, C., Dmochowski, R.R., Goehring, E.L., Nguyen‐Khoa, B., et al. (2010) Epidemiology and Healthcare Utilization of Neurogenic Bladder Patients in a Us Claims Database. NeurourologyandUrodynamics, 30, 395-401. https://doi.org/10.1002/nau.21003
[6]
Chinese Association of Rehabilitation Medicine, Committee on Rehabilitation Nursing, Cai, W.Z., Meng, L. and Li, X.Y. (2017) Practice Guidelines for Neurogenic Bladder Nursing (2017 Edition). Journal of Nursing, 32, 1-7.
[7]
Zhang, F., Zhang, J., Zhong, H., et al. (2022) Effects of Moxibustion Combined with Auricular Point Pressing on Urinary Retention in Neurogenic Bladder. Medical & Pharmaceutical Journal of Chinese People’s Liberation Army, 34, 78-82.
[8]
Zhang, B. and Wu, M. (2023) Chinese Internal Medicine. 11th Edition, China Press of Traditional Chinese Medicine, 289-293.
[9]
Zhu, J,. Sun, Z., Cui, Y., et al. (2022) Clinical Observation of Deep Electroacupuncture at Baliao Points in the Treatment of Neurogenic Bladder after Spinal Cord Injury. Journal of Guangzhou University of Traditional Chinese Medicine, 39, 328-333.
[10]
ASIA and ISCoS International Standards Committee (2020) The 2019 Revision of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Spinal Cord, 58, 256-261.
[11]
Urinary Control Group and Chinese Urological Association (2021) Guidelines for the Diagnosis and Treatment of Neurogenic Bladder (2021 Edition). Chinese Journal of Urology, 42, 721-730.
[12]
National Administration of Traditional Chinese Medicine (2020) Standards for Diagnosis and Therapeutic Effects of Traditional Chinese Medicine Diseases and Syndromes. Nanjing University Press, 49-51.
[13]
Chinese Association of Rehabilitation Medicine (2022) Guidelines for Nursing Practice of Neurogenic Bladder (2022 Edition). Chinese Journal of Nursing, 57, 645-652.
[14]
Shen, X.Y. (2016) Meridians and Acupoints. 10th Edition, China Press of Traditional Chinese Medicine, 103.
[15]
He, J.G., Song, Q., Wu, L., Fan, W.J., Jin, S.S., Wang, Q., Zhang, Q. and Zhang, X.S. (2022) Clinical Efficacy of Acupuncture Combined with Rehabilitation Training in the Treatment of Neurogenic Bladder after Spinal Cord Injury. Journal of Chinese Geriatric Health Care, 20, 35-38.
[16]
Zhu, J.M. Sun, Z.R., Cui, Y. and Yin, H.N. (2022) Clinical Observation on Electroacupuncture and Deep Needling at Baliao Points for the Treatment of Neurogenic Bladder after Spinal Cord Injury. Journal of Guangzhou University of Chinese Medicine, 39, 328-333.
[17]
Li, W.G. and Wang, X.D. (1998) Introduction to the New Edition of Clinical Criteria for Diagnosis and Improvement of Diseases. HospitalAdministrationJournalofChinesePeople’sLiberationArmy, 5, 299.
[18]
Guan, H., Shi, J., Guo, X.F., et al. (2001) International Standards for the Neurological Classification of Spinal Cord Injury (Revised 2000). ChineseJournalofRehabilitationTheoryandPractice, 7, 49-52.
[19]
Niu, L., Li, Y.J., Peng, J.F., Qin, H.W., Guo, N., Sun, Y.B., Liu, H.Y., Zhang, S.Q. and Niu, Y.Q. (2022) Clinical Study on Acupoint Application of Wenyang Tongli Formula for the Treatment of Urinary Retention due to Neurogenic Bladder after Spinal Cord Injury. JournalofEmergencyinTraditionalChineseMedicine, 31, 993-996, 1008.
[20]
Shang, Z.H., Jia, C.S., Yan, H., et al. (2022) Injecting RNA Interference Lentiviruses Targeting the Muscarinic 3 Receptor Gene into the Bladder Wall Inhibits Neurogenic Detrusor Overactivity in Rats with Spinal Cord Injury. Neurourology and Urodynamics, 41, 890-898.
[21]
Gomelsky, A., Lemack, G.E., Castano Botero, J.C., et al. (2023) Current and Future International Patterns of Care of Neurogenic Bladder after Spinal Cord Injury. World Journal of Urology, 41, 1235-1243.
[22]
Zhu, Y., Bai, H., Jin, Y., et al. (2022) Application of Auricular Seed Pressing in Patients with Urinary Retention after Cerebral Angiography. JournalofNursingScience, 37, 45-47.
[23]
Wang, L. and Zhu, M. (2023) Observation on the Curative Effect of Auricular Point Pressing Combined with Traditional Chinese Medicine in the Treatment of Diabetic Neurogenic Bladder. JournalofClinicalChineseMedicine, 15, 98-100.
[24]
Zhu, X.J., Bai, H.H., Jin, Y.J., et al. (2017) Application of Auricular Seed Embedding in Patients with Urinary Retention after Cerebral Angiography. JournalofNursing, 32, 56-57.
[25]
Kim, J.H., Park, S.Y. and Lee, J.S. (2022) Auricular Point Stimulation Modulates Bladder Function via the Vagus Nerve Pathway in Rats with Spinal Cord Injury. JournalofEthnopharmacology, 298, Article ID: 115568.
[26]
Kreder, K.J., Chancellor, M.B. and Yoshimura, N. (2021) Intermittent Catheterization for Neuro-Genic Lower Urinary Tract Dysfunction: A Systematic Review. EuropeanUrology, 80, 512-520.
[27]
Li, H., Li, B., Xu, A., et al. (2022) Effect of Intermittent Catheterization on Bladder Function Recovery in Patients with Spinal Cord Injury. JournalofChinaMedicalUniversity, 51, 721-724.
[28]
Guan, M. (2023) Analysis of Flora Distribution and Drug Sensitivity of Urinary Tract Infections in Patients with Spinal Cord Injury. MedicalJournalofAirForce, 39, 167-169.
[29]
Wu, Y. and Yang, Y. (2023) The Effect of Electroacupuncture at Baliao Points Combined with Rehabilitation Training on Urodynamics of Neurogenic Bladder after Stroke. JournalofEmergencyinTraditionalChineseMedicine, 32, 678-680.
[30]
Zhang, Y., Yu, H., Li, H., et al. (2022) The Effect of Pelvic Floor Biofeedback Combined with Bladder Function Training on the Efficacy and Quality of Life of Patients with Neurogenic Bladder after Spinal Cord Injury. ChineseJournalofRehabilitation, 37, 345-348.
[31]
Ma, F., Li, W., Bai, J., et al. (2023) Clinical Observation of Electroacupuncture at Baliao Points as the Main Treatment for Neurogenic Bladder after Spinal Cord Injury. ShanghaiJournalofAcupunctureandMoxibustion, 42, 245-249.
