Hisashi Honjo

Treatment of monosymptomatic nocturnal enuresis by acupuncture: A preliminary study

Objectives: This study was designed to clarify the clinical usefulness of acupuncture as a treatment option for monosymptomatic nocturnal enuresis, and evaluate the mechanisms of its effect.

Acupuncture on clinical symptoms and urodynamic measurements in spinal-cord-injured patients with detrusor hyperreflexia.

Objectives: We investigated the possible use of acupuncture for the treatment of urinary incontinence caused by detrusor hyperreflexia in patients with chronic spinal cord injuries. Methods: A total of 13 patients (11 males, 2 females) suffering from urinary incontinence due to spinal cord injuries were treated by acupuncture, which was carried out with disposable stainless steel needles inserted into the bilateral BL-33 (Zhongliao) points on the skin of the third posterior sacral foramina. Urodynamic studies were also performed before acupuncture, immediately after the 1st acupuncture and 1 week after the 4th acupuncture. In 6 patients, these urodynamic studies were performed again 1 month after the 4th acupuncture. Results: No side effects were recognized throughout the treatment period. Of the 13 patients, incontinence disappeared in 2 (15%) and decreased to 50% or less compared to baseline in a further 6 (46%). Maximum cystometric bladder capacity increased significantly from 76.2 ± 62.3 to 148.1 ± 81.5 ml 1 week after the 4th acupuncture (p < 0.01). In the 6 patients in whom cystometry was repeated 1 month after the 4th acupuncture, bladder capacity decreased from 187.5 ± 90.4 ml 1 week after the 4th acupuncture to 128.3 ± 93.4 ml. Conclusion: In spinal cord injury patients acupuncture could represent another valuable therapeutic alternative to the treatment of urinary incontinence caused by detrusor hyperreflexia.

The Effects of Sacral Acupuncture on Acetic Acid-induced Bladder Irritation in Conscious Rats

OBJECTIVES To investigate the effects of sacral acupuncture on acetic acid-induced bladder irritation using cystometry in conscious rats, with particular focus on effects on afferent fibers of the bladder. METHODS A total of 40 female Sprague-Dawley rats weighing 200-270 g were used. The animals were divided into 5 groups: (1) rats with bladder overactivity induced by acetic acid, without sacral acupuncture stimulation (irritated bladder group); (2) rats treated with sacral acupuncture stimulation after induction of bladder overactivity by acetic acid (acupuncture stimulation group); (3) rats treated with sacral acupuncture stimulation after capsaicin desensitization (capsaicin-desensitized group); (4) rats treated with atropine (atropine injection group); and (5) rats treated with sacral acupuncture stimulation after nonacetic acid infusion (nonirritated bladder group). Cystometry was carried out without anesthesia, and the following variables were measured in all animals: intercontraction interval (ICI), basal pressure, threshold pressure, and micturition pressure. RESULTS In the acupuncture stimulation group, sacral acupuncture stimulation resulted in a 140.1 +/- 5.9% increase in ICI after acetic acid-induced irritation to an interval similar to baseline (P = .072). A significant difference in the percent of ICI increase was observed between the acupuncture stimulation and irritated bladder groups (P < .01). In the capsaicin-desensitized groups and acupuncture stimulation groups, no significant differences in ICI occurred, before and after acupuncture. CONCLUSIONS Sacral acupuncture could contribute to improve acetic acid-induced bladder irritation through inhibition of capsaicin-sensitive C-fiber activation.

Analysis of bladder diary with urinary perception to assess overactive bladder symptoms in community-dwelling women.

Bladder diaries including bladder perception grades were analyzed to assess overactive bladder (OAB) symptoms in community‐dwelling women 40 years of age or older.

Sleep duration is an independent factor in nocturia: analysis of bladder diaries

To analyse the relationship between the number of nocturia episodes and other variables obtained from a bladder diary, with special attention to the duration of sleep, as nocturia is closely related to sleep disorders.

Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality.

Study Type – Therapy (case series)

Association of Serum Carotenoid Levels With Urinary Albumin Excretion in a General Japanese Population: The Yakumo Study

Background Albuminuria is a risk factor for not only nephropathy progression but also cardiovascular disease. Oxidative stress may have a role in the positive association between albuminuria and cardiovascular disease. Methods This cross-sectional study investigated the associations of serum levels of carotenoids, which are dietary antioxidants, with albuminuria among 501 Japanese adults (198 men, mean age ± SD: 66.4 ± 10.0 years; 303 women, mean age ± SD: 65.4 ± 9.8 years) who attended a health examination. Serum levels of carotenoids were determined by high-performance liquid chromatography. Logistic regression analysis was used to estimate odds ratios (ORs) with 95% CIs for albuminuria after adjustment for age, body mass index, smoking habits, drinking habits, hypertension, diabetes mellitus, and dyslipidemia. Results Prevalence of albuminuria was 15.4% among men and 18.1% among women. Among women with albuminuria, geometric mean serum levels of canthaxanthin, lycopene, β-carotene, total carotenes, and provitamin A were significantly lower than those of normoalbuminuric women. Adjusted ORs for albuminuria among women in the highest tertiles of serum β-carotene (OR, 0.45; 95% CI, 0.20–0.98) and provitamin A (OR, 0.45; 95% CI, 0.20–0.97) were significantly lower as compared with those for women in the lowest tertile. There were no associations between serum carotenoids and albuminuria in men. Conclusions An increased level of serum provitamin A, especially serum β-carotene, was independently associated with lower risk of albuminuria among Japanese women.

Impact of convenience void in a bladder diary with urinary perception grade to assess overactive bladder symptoms: A community-based study†‡

Bladder diaries including bladder perception grade were analyzed to assess convenience void (CV) in community‐dwelling women 40 years of age or older.

Urge Perception Index of Bladder Hypersensitivity

PURPOSE By analyzing bladder diaries with patient self-reported urinary perception grades, we developed the urge perception index, a quantitative measure of bladder hypersensitivity. We evaluated the impact of the urge perception index on the definition of overactive bladder severity. MATERIALS AND METHODS We retrospectively evaluated the records of 69 female patients who visited our outpatient clinic with the complaint of storage symptoms. Patients were asked to complete the overactive bladder symptom score and a 3-day bladder diary with self-reported grading of urinary perception on a range of 1 to 5 per void. Overactive bladder was diagnosed in 43 patients and nonoveractive bladder was diagnosed in 26. The urge perception index was defined as voided volume divided by the urinary perception grade at each void. RESULTS We analyzed 1,578 reported voids. According to the urinary perception grade, urge perception index values for overactive bladder were significantly lower than those for nonoveractive bladder (grades 1 to 4 p <0.001). The average ± SD urge perception index in 3-day bladder diaries was lower in overactive than in nonoveractive bladder cases (55 ± 28 vs 133 ± 73, p <0.0001). The most severe (lowest) single urge perception index value during the 3 days was significantly lower in patients with overactive than with nonoveractive bladder (mean 20 ± 12 vs 62 ± 40, p <0.0001). There were negative linear correlations of the urge perception index with total overactive bladder symptom scores (r = -0.598, p <0.0001) and with an urgency symptom score (r = -0.557, p <0.0001). CONCLUSIONS The urge perception index, an integrated parameter of patient reported bladder perception and voided volume, could be promising to quantify the severity of overactive bladder or bladder hypersensitivity by bladder diary analysis.