Treating Pediatric Bedwetting or Nocturnal Enuresis with Acupuncture

Bedwetting, or Nocturnal Enuresis is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary (PNE) when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis (SNE) is when a child or adult begins wetting again after having stayed dry.

Bedwetting is often genetic and often runs in families.

The acupuncture treatment is targeted to improve the communication between the nervous system and the bladder muscles, and reduce the mistaken signals between them. Acupuncture is relatively effective in treating this condition. Besides treating the underlying cause of this disorder, acupuncture can also reduce the nervousness and emotional stress brought upon the patients by this disorder.   There are studies that support that, “Acupuncture can influence spinal micturition centers and parasympathetic innervation to the urinary tract and is known to modulate brain function via the descending serotonergic system.”

According to TCM, the pathology of bedwetting is always characterized by deficiency pattern of the Lungs, Spleen or Kidneys:

• Lungs governs Qi in general, also provide Qi to the bladder to control urine.
• Spleen Qi raises Qi in general, and a sinking spleen Qi may be unable to control urine, which leaks out.
• The kidneys form urine and the bladder stores and excretes urine. If the kidneys are deficient they are unable to support the function of the bladder in regulating urinary output. In addition, the kidneys in TCM cheks the two lower orifices. 

General acupuncture points:

• Ren 3 (Zhong Ji) 
• Ren 4 (Guanyuan)
• SP 6 (San Yin Jiao)
• LIV 8 (Qu Quan)
• EX-UE-17 (Ye niao dian): It locates on the palmar surface of little finger, in the middle of the transverse crease of the distal interphalangeal joint. Before sleeping, the infant can make themselves acupresure with their nail without hurting the skin.

Indirect moxibustion with a cigar-mugwort

It is applied moxa from left to right as well: From BL20 Pishu (left) to BL20 Pishu (right), follow BL23 Shenshu (right), and then, BL23 Shenshu (left)..., for 10-15 minutes.

Kidney deficiency:

• BL23 (Shenshu)
• BL25 (Da chang shu)
• BL28 (Pang guang shu)
• KID3 (Taixi)
• KID1 (Yong Quan)
• REN 6 (Qihai)

Spleen and Lung deficiency:

• Ren 3 (Zhong Ji)
• SP 6 (San Yin Jiao)
• LIV 8 (Qu Quan)
• EX-UE-17 (Ye niao dian)
• LIV11 (Yinlian)
• LIV3 (Taichong)
• H7 (Shenmen)  
• SP9 (Yin Ling Quan)
• LIV1 (Dadun)
• BL13 (Feishu)
• BL20 (Pishu) 

Efficacy of acupuncture as a treatment for bedwetting

• Prospective randomized trial using laser acupuncture versus desmopressin in the treatment of nocturnal enuresis did not find significant difference between the 2 groups indicating acupuncture can be a valid alternative.
• A Cochrane review by Glazener et al found that acupuncture seems to offer some benefits over sham acupuncture and a combination of drug therapies. A systematic review by Bower et al also found tentative evidence for therapeutic benefits. Both reviews suggest further research be conducted with larger scale trials and greater methodologic quality.