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Nocturnal Enuresis: Acupuncture Treatment


Nocturnal enuresis, affecting an estimated 15-30% of school-age children, is a condition where 85% of affected children have a singular symptom without other diseases or daytime urinary incontinence. Acupuncture has shown good effectiveness in these singular symptom cases.


Acupuncture's effectiveness for nocturnal enuresis has been widely reported in clinical studies within China and confirmed by researchers in other countries. For treating this condition, daily or alternate day body acupuncture is often required. For needle-phobic or school-going children, auricular acupressure is a suitable alternative. After auricular acupressure treatment, most children either have no dreams or wake up in time to urinate. Sometimes, an initial increase in nocturnal urination is observed after embedding needles, but this usually improves subsequently.


A specific massage point for nocturnal enuresis is located between the first and second phalanges on the little finger. The first treatment is performed in front of the parents, who then repeat it at home daily for 10 minutes over 20 days. This simple and easy massage technique is a feasible alternative for needle-phobic young children.


For stubborn cases, a comprehensive examination for various causes is necessary. These can include psychological habits, incomplete brain development, or local irritative factors such as a long prepuce, bladder infection, or spina bifida occulta. For such children, removing the source of irritation is crucial for a cure, like circumcision for an overly long prepuce. If a child's deep sleep at night due to excessive daytime play leads to enuresis, limiting their activities from the afternoon onwards is advised. In cases where deep sleep occurs regardless of activity level, adjusting the sleep phase is considered. Since enuresis often happens during dreaming at night, a daytime nap can reduce the duration of dream sleep at night, thus it's suggested that children take a half-hour nap daily.


Many enuretic children have a large volume of nighttime urine, suggesting a possible reduction in antidiuretic hormone levels. A strategy is to train bladder holding during daytime to increase the bladder's threshold for urinary volume stimulation. This approach can reduce the urge to urinate when the bladder is full at night, thereby reducing enuresis. This method is preferable to restricting water intake in the evening since thirst often indicates the body's need for water.


The mechanism of acupuncture treatment for nocturnal enuresis is not entirely clear, but it is generally believed to be related to the regulation of cortical arousal functions in the brain. It may also involve increasing the bladder's threshold for urinary volume stimulation and boosting antidiuretic hormone production.

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