(274) Q & A: Bladder problem

[HB KIM]

Q:  I've got a patient who had prostate cancer and had his prostate removed 3 years ago. He's recovery went pretty well and he appears to be "free" of cancer, but he was left with bladder problems. He has constant bladder pressure and discomfort if sitting or standing (ok when lying down), consistently yellow urine, and incontinence - when he needs to go, he has to race to the bathroom immediately because he looses control of the urine quickly. He cannot leave the house for long periods of time now because of this problem. He also has sexual dysfunction since the surgery and long term depression due to a previous car accident and severe cervical spine injury (15 years ago). Any advice on treating incontinence and sexual dysfunction due to surgery would be greatly appreciated.


A:  HERBAL FORMULA
With the above information, I can think of the following options.  Please diagnosis your patient with 8 principles differentiation (excess/deficiency, heat/cold) before you choose the herbal formula.

1. Ba Wei Di Huang Wan + Shan Dou Gen, Yi Yi Ren
2. Bu Zhong Yi Qi Tang + Zhu Ling Tang
3. Empirical formula*

Empirical formula*
8.0g  Dang Gui
4.0g  Rou Gui
4.0g  Xiao Hui Xiang
4.0g  Bai Shao
4.0g  Chai Hu
4.0g  Ren Shen
3.2g  Chuan Lian Zi
3.2g  Yan Hu Suo
3.2g  Ze Xie
6.0g  Tu Si Zi
4.0g  Lu Rong
2.0g  Fu Zi

ACUPUNCTURE
If heat, tonify UB (Taiyang cold); +LI1, +UB67, -ST36, -UB40
If cold, tonify KD (Shaoyin heat); +LU8, +KD7, -SP3, -KD3