MEDICAL ACUPUNCTURE IN UROLOGY: A COST EFFECTIVE WAY OF TREATING COMMON AND ENIGMATIC PROBLEMS
Bruce R. Gilbert, M.D.,Ph.D.
Complementary and Alternative Medicine (CAM) products and services are in demand. It is estimated that half the United States population who seek medical attention, use CAM either alone or in conjunction with conventional medical treatments. This accounts for the more than 500 million office visits made each year to CAM practitioners. Also, out-of-pocket expenses of over 27 billion dollars for CAM products and services is comparable for that of all conventional physician services in this country. However, excluding products associated with CAM, the cost per patient for treatment is usually less than one third of that of conventional medical care. This is the allure for both private and group payers.
The trend in patients seeking CAM practitioners is being addressed by many medical schools in this country. In a survey conducted in 1998 of 124 members of the Association of American Medical Colleges, courses in CAM were being offered by 53 American Medical Schools. In fact, due to the growing interest in the use of acupuncture in this country during the past 15 years, well over 1,000 physicians already in practice are completing their certification in medical acupuncture each year.
Interest in medical acupuncture recently accelerated due to literature appearing in peer reviewed journals documenting the effectiveness of acupuncture in a wide range of applications. In addition, in 1998 the National Institute of Health convened a consensus conference to evaluate the efficacy of Acupuncture. This conference brought together experts in medicine, acupuncture and biostatistics. Their goal was to evaluate the plethora of written material available on the use of acupuncture in various medical disciplines. The result of their efforts was nothing less than spectacular. It provided one of the first critical reviews of this 3,000 year old discipline, providing documentation of the efficacy of acupuncture.
In addition to musculoskeletal and neurologic disorders that are known to be reliably treated with acupuncture, digestive disorders and respiratory disorders are recognized by the World Health Organization (WHO) to be effectively treated by acupuncture. Many urologic and gynecologic problems are also often well treated by acupuncture. For men, these include erectile dysfunction, sperm quality, pain associated with prostate cancer, prostatitis (including chronic pain syndromes) and stress reduction. There has also been some encouraging preliminary work on improvement in voiding symptoms with BPH. For women, these include dysmenorrhea, incontinence, endometriosis, pelvic pain, hormonal irregularity and menopausal related disturbances (e.g., insomnia, hot flushes, memory, anxiety). There has also been some preliminary work suggesting an improvement in vaginal lubrication and libido. What is often most astonishing to physicians frustrated by the failure of conventional medicine to treat enigmatic problems (e.g., prostadynia, premature ejaculation, nocturnal enuresis etc.) is the effectiveness of acupuncture.
Medical acupuncture is the term used to describe acupuncture performed by a doctor trained and licensed in western medicine who has also had thorough training in acupuncture as a specialty practice. Such a physician can use one or the other approach, or a combination of both as necessary to treat a given condition. Acupuncture involves therapeutic insertion of solid needles in various combinations and patterns usually along classically described acupuncture channels. In the traditional teaching, it is a method of encouraging the body to promote natural healing and to improve functioning.
Our current scientific understanding is that needling specific acupuncture points causes simultaneous activation of multiple physiologic systems. Dr. Joseph M. Helms, a leader in physician education in acupuncture in the United States, details in his core textbook for physicians entitled “Acupuncture Energetics” clinical and basic science studies which elucidate acupuncture’s impact on several body systems, including:
- Nervous system: peripheral afferent transmission, perivascular sympathetic fiber conduction and the central neurohumoral and neuropeptide mechanisms.
- Circulatory system: transporting biomolecular elements locally and centrally
- Lymphatic system: serves as a medium for ionic flow along fascial planes and interstitial fluid.
Therefore, a contemporary view of acupuncture involves both neuroanatomical constructs and physiologic systems which assists with diagnosis and therapeutic decisions. What is so fascinating to many patients is that the relatively painless needling is most often done on the extremities, often far from the site of the primarily problem. Each treatment session is usually one half hour. For musculoskeletal pain syndromes improvement usually occurs with one or two treatments. Urologic conditions often require 4 to 6 sessions to begin to see improvements but usually with a 10 – 12 treatment course. Herbal supplements are usually added to treatment for Urologic conditions. There are few contraindications for acupuncture and significant complications are rare.
Acupuncture is not a panacea. However, for many patients, it offers the potential for improvement of specific and often elusive, urologic problems.
If you would like more information please see Frequently Asked Questions (FAQ) or The American Association of Acupuncture’s Brochure or contact:
If you would like more information please contact
Bruce R.Gilbert, M.D., Ph.D. at 516-487-2700 or firstname.lastname@example.org.