male urinary obstruction from blood stasis and without damp heat--Please answer the question!

[Guest guest]

Dear Group,

 

A simple request:  PLEASE, answer the request that is tendered.  I know very

well about determining differential diagnosis, and didn't ask about  an

acupuncture protocol because, a) what I was doing was working, and b) my

immediate concern was much better addressed by herbs, thus the specificity of my

question.  I received multiple answers NOT to what I asked, plus additional

questions about my differential diagnosis. I can't tell you how frustrating it

is to ask one thing and pedantically receive suggestions marginally related! 

 

That being said, much thanks to Kokko and Edith.  Hopefully, I will report more

good news concerning this patient.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dear Colleagues,

 

 I have a very athletic patient in his 50s, who 5 years ago came down with a

severe case of Guillain-Barre syndrome.  Though  he has difficulty walking, he

has built himself back up by swimming an hour daily.  When I started treating

him about a month ago, both proximal pulses were empty, and slow but as would be

expected, the distal pulses on the right wrist are robust. I have been treating

him with a combination of You Gui wan and Xiao Huo Luo Dan, along with

acupuncture and heat (a combination of infrared heat and moxa, alternatingly) . 

The first condition that I treated him for was ulcerated sores or his feet and

toes with numbness, similar to diabetics with neuropathy.    The sores have now

healed completely, and the extremities though still cold are less so.  His

proximal pulses are now thready and a little slow and weak.  None of his pulses

give any indication of a slippery or rapid quality. All the above

is background to my actual question:

 

His chief complaint is urinary obstruction and unrelenting pain upon urination. 

In order to urinate he has to gently massage his penis, and even then only a few

drop come out.  It is very painful, and he is afflicted by it day and night,

every half hour or so.   But wait, before you jump on the prostatitis and damp

heat bandwagon,  first, as I mentioned above neither his pulses nor tongue

reflect that at all.  Second, he saw his urologist yesterday, who upon

examination and testing said that there is no evidence of infection, and though,

his prostate is marginally enlarged, it is consistant with someone his age, and

certainly contributes little to his current condition.  Also, there is no

urinary retention, and so a catheter would not be helpful at all.  The current

condition,  he said,  was clearly the result of scar tissue and stricture, the

result of the GBS from 5 years ago in the penis and urethra.  He is open

to herbs

and clearly, what I need to prepare is a formula that will invigorate blood

stasis,  while continuing to warm and open the channels,  boost Kidney Yang and 

nourish Kidney Jing.  One other unpleasant side effect:  When he bears down too

hard trying to urinate, he involuntarily defecates.

   

The benefit of your experience would be appreciated.