Presentation summary

This case report presents a 57-year-old man with persistent lower urinary tract symptoms (LUTS) due tobladder diverticulum, detrusor-sphincter dyssynergia (DSD), and recurrent urinary tract infections (UTIs). Despite comprehensive urological treatments, including partial cystectomy, GreenLight laser TURP,cystostomy, vasectomy, botulinum toxin injection and medication, significant residual urine and symptoms remained. Acupuncture using classical points, Dong’s extraordinary points, and electroacupuncture wasintroduced, leading to residual urine reduction from 79 mL to 2 mL and symptom relief. This case highlights thepotential of acupuncture as a promising complementary treatment for refractory LUTS.

Introduction :
LUTS are common in older adults, often arising from BPH, bladder diverticulum, or neurogenic dysfunction likeDSD. Even with advanced surgeries and pharmacotherapy, some cases remain unresolved. Acupuncture may improve genitourinary function by modulating neuromuscular control.

Methods :
Weekly acupuncture began November 10, 2023. Fixed points included bilateral LI4, SP6 and SP9 with electroacupuncture, Xia San Huang, Shen Guan, and CV2. LI4 regulated autonomic tone; SP6 and SP9enhanced detrusor function; Dong’s points tonified kidney Qi; CV2 stimulated the bladder wall. Needles were retained for 15 minutes.
Results
Prior to acupuncture, the patient had undergone partial cystectomy, TURP, cystostomy, vasectomy, andsphincter botulinum injection, yet residual urine remained 79 mL and LUTS persisted. After acupuncture,residual urine progressively decreased to 2 mL (Feb 2025). Urinary symptoms also markedly improved.

Conclusion :
Acupuncture may offer effective adjunctive therapy for refractory LUTS related to bladder diverticulum andDSD, especially when conventional surgeries and medications have limited efficacy. Combining classical and Dong’s points with electroacupuncture may enhance neuromuscular recovery and bladder function.