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Shorts

briefed by Jule Rlotter

Acupuncture for Overactive Bladder


A randomized, placebo-controlled trial, conducted by
Sandra L. Emmons, MD, and Lesley Otto, MD, found that
four weekly acupuncture t r e a t m e n t s improved urge
incontinence and bladder overactivity (Obstetrics &
Gynecology, July 2005). At present, frequent urination and
urge incontinence are usually treated witb medication, sucb
as oxybutynin, and/or pbysical and behavioral tberapy.
Oxybutynin can reduce urge incontinence episodes hy 69%
and urinary frequency by 19%, but less than one-fiftb of
patients continue taking drugs for bladder overactivity
beyond six montbs because of the side effects. Oxybutynin's
side effects include tachycardia, palpitations, drowsiness,
dizziness, hallucinations, rash, nausea, and/or vomiting.
Pbysical and behavioral therapy can reduce urge incontinence
episodes by 80% and urinary frequency by 18%, but the
improvement decreases within three montbs of treatment.
Each of the 85 women enrolled in this acupuncture study
urinated more than 8 times per day and experienced urgeassociated incontinence at least twice during a 3-day period.
Women with hematuria or untreated urinary tract infection
and those on medication for incontinence or receiving
acupuncture for any condition were excluded from the trial.
All participants had cystometric testing, kept a three-day
voiding diary, and completed an incontinence impact
questionnaire, a urinary distress inventory, and validated
quality-of-life inventories before treatment hegan and, again,
two to four weeks after completing tbeir acupuncture
treatments. Each woman was randomly assigned to the
treatment or the placebo group and received one acupuncture
treatment for four weeks. Those in the treatment group were
needled at points that were expected to improve tbeir bladder
symptoms: bilaterally at SP6 (inner legs), BL 39 (outer knee
fold), BL 28 (low hack) and midline at CV 4 (low-abdomen).
Those in the placebo group were given an acupuncture
treatment tbat was intended to promote relaxation only:
hilateral sites GB 31 (outer thigh), ST 36 (outer legs), LB 12
(upper back) and midline CV 12 (epigastrium). The number
of incontinent episodes declined significantly in both groups:
59% for the treatment group and 40% for placebo group. The
difference between tbe two groups was not significant.
However, the bladder treatment group did experience
"significant improvements in bladder capacity, urgency,
frequency, and quality-of-life scores as compared with women
wbo received placebo acupuncture treatments." Urinary
frequency, for example, declined by 14% in the active group,
compared to 4% in tbe placebo. The authors say tbat their
findings "need to be confirmed with a larger sample, and
extended to see whether the effect is sustained."
Eramons, Sandra L., MD & Otto. Lesley, MD, Acupuncture for Overactive Bladder,
Obstetrics & Gyneiuiogy .My 2005

Cadmium & Kidneys


Swedish researchers discovered that renal tubular damage
may occur at lower levels of exposure to cadmium tban
previously expected (Occup Environ Med 2000;57:668-672).
When inhaled or ingested, the heavy metal cadmium tends
TOWNSEND LETTER tor DOCTORS & PATIENTS - OCTOBER 2005

to accumulate in the kidneys where it damages tubules and


glomeruli in tbe kidneys' nephrons. Cadmium is released into
tbe air and waterways during metal refining, the production
of nickel-cadmium batteries and, perbaps most importantly,
tbe production and use of artificial pbospbate fertilizers. Food
crops and tobacco absorb cadmium from tbe soil. Tbe
cadmium tben enters those who eat the crops or who breathe
tbe contaminated tobacco smoke. Shellfish, mussels, lobsters
and other water creatures - contaminated by run-off from
fertilized fields and industrial pollution tbat enters surface
water - can also accumulate cadmium.

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