Difficult Urination


Urination difficulties can take many forms. Sometimes, it can be difficult to start urinating, or the urine stream may be weak or broken. In other cases, it may feel like you haven't completely emptied your bladder. In general, these problems are not associated with pain. However, when pain is present, the condition is usually referred to as painful urination. A more severe form of urination difficulty is obstructed urination, which occurs when the bladder is full but very little or no urine is passed. This can be a serious medical emergency and requires immediate hospital treatment. In the past, different treatment methods were used depending on the type of urinary problem. For example, in the Tang Dynasty (618-907 CE), a catheter made from a spring onion leaf was used, along with herbal decoctions, to treat urinary problems.


The external pathogens of wind-heat and damp-heat are often the culprits of acute urinary issues. These pathogens enter the body through the tai yang channel and Lungs, disrupting the flow of qi and fluids. This can lead to difficulty urinating and swelling in the upper body. In individuals with preexisting Kidney deficiency, the likelihood of external pathogen invasion increases, especially through sexual intercourse or bowel movements. When damp-heat is the cause, symptoms are typically focused in the Bladder with minimal systemic effects.

The emotions of frustration, anger, resentment, sexual tension, repressed emotion and stress can interfere with the smooth flow of energy in the Liver channel, hindering the movement of qi in the lower burner. If this obstruction persists, it can lead to the build-up of heat or fire, which can affect the Bladder and urethra. This blockage of energy can also prevent blood from flowing properly, leading to stagnation of both qi and blood. This can cause the Spleen to become weakened, leading to a deficiency of qi and potential leakage of blood from blood vessels. In some cases, this can result in the development of dampness, which can sink into the lower burner and create a cycle of damp-heat.

The overindulgence of high-fat, sugary, spicy, or alcoholic foods creates an excess of dampness and heat in the digestive system, which eventually settles in the lower abdominal region. This prolonged buildup of dampness and heat can eventually harden into masses that obstruct the urinary tracts and cause blood stagnation. Consuming too many cold or raw foods can weaken the digestive system, leading to a build-up of dampness. This chronic deficiency in the digestive system can eventually drain the kidneys, resulting in weak urine flow and difficulty starting and maintaining a steady stream.

The imbalances of overwork, worry, and excessive mental activity, combined with poor diet and sedentary habits, can lead to a weakening of the qi in the Spleen. This can prevent the natural ascent of the Spleen qi, disrupting the balance required for the proper disposal of waste materials. When the Spleen fails to properly regulate the "clear and turbid," it can cause them to mix, preventing their proper descent into the Bladder and potentially leading to cloudy urine. Spleen yang deficiency, whether from a cold diet or a decline in overall qi, can affect the body's ability to metabolize fluids. Instead of being processed and eliminated through the Bladder, these fluids may congeal into dampness or accumulate in the limbs and tissues as edema. Weak yang can also cause a general weakness in qi movement and a lack of force in urine expulsion. Kidney yang qi can be inherited or develop over time, through chronic illness, exposure to cold environments, or excessive physical labor. It can also be damaged by excessive sexual activity. In some cases, especially among younger individuals, the Kidney qi may be weakened while the Kidney yang remains intact, resulting in a lack of cold symptoms. Kidney yin can be damaged by febrile diseases, overwork, insufficient sleep, and recreational drug use. It may also be weakened by aging and excessive sexual activity.

As time goes on, various issues can arise within the urinary tract due to a range of factors. In some cases, chronic conditions may lead to the formation of urinary calculi, which can be caused by a combination of damp-heat or Kidney yin deficiency. These types of stones often stem from dietary issues and the accumulation of damp-heat in the lower body. In other cases, Kidney yin deficiency can cause fluids to thicken and solidify, leading to the development of stones.

Therapeutic approaches

The two approaches to managing urinary difficulties stem from the underlying cause of the condition. In some cases, the issue may be due to an excess, in which case removing the offending agent or addressing the flow of qi can often provide relief. In other instances, the problem may be rooted in a deficiency, requiring a more gradual approach that involves strengthening the organ system responsible for fluid metabolism and stimulating yang movement. This type of treatment may take several months to produce lasting results.

In cases of acute retention, alternative therapies such as tui na or electro-acupuncture may be effective. If these methods fail, hospitalization and catheterization may be necessary to prevent potential kidney damage. For milder cases, particularly in children, sitting in a warm bath or listening to running water can help stimulate urination.

Tui Na To use this technique, apply pressure from above towards the pubic bone using points Ren-6, Ren-5, and Ren-4. It is important to have a device ready to catch the urine, as this technique may cause immediate release.

Electro-Acupuncture To use this method, stimulate points ST-28, Sp, Sp-6, or Sp-9 using high frequency stimulation. ST-28 should be needled carefully and superficially in individuals with distended bladders. This technique may also result in immediate release of urine.