References

1. Chang PL. Urodynamic studies in acupuncture for women with frequency, urgency and dysuria. J Urol 1988;140:563-566.

2. Gerisson G, Wang Y, Lindstrom S, Fall M. Traditional acupuncture and electrical stimulation of the posterior tibial nerve. J Urol 1993; 27:67-70.

3. Lyons P. Acupuncture treatment for interstitial cystitis: a case report. Med Acupunct 2003;14:43-45.

4. Maher CF, Carey MP, Dwyer PL, Schlutter PL. Percutaneous sacral nerve root neuromodulation for intractable interstitial cystitis. J Urol 2001;165:884-886.

5. Phillip T, Shah PJR, Worth PHL. Acupuncture in the treatment of bladder instability. Br J Urol 1988;61:490-493.

6. Pigne A, De Goursac C, Barrat J. Acupuncture and unstable bladder. In: Proceedings of 15th Annual Meeting of International Continence Society, London, 1985:186-187.

7. Shaoguang W. Electroacupuncture treatment for constipation due to spasmodic syndrome of the pelvic floor. J Tradit Chin Med 2001; 21(3):205-206.

8. Wedenberg K, Moen B, Norling A. A prospective randomized study comparing acupuncture with physiotherapy for low-back pain in pregnancy. Acta Obstet Gynecol Scand 2000;79: 331-335.

9. Slocumb J. Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome. Am J Obstet Gynecol 1984;149(5):536-543.

10. Weiss J. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency for interstitial cystitis and the urgency-frequency syndrome.J Urol 2001;166:2226-2231.

11. Powell J, Wojnarowska F. Acupuncture for vulvodynia. J R Soc Med 1992;92:579-591.

12. Martin DC, Ling FW. Endometriosis and pain. Clin Obstet Gynecol 1999;42:664-686.

13. Steege JF, Stout AL, Somkuti SG. Chronic pelvic pain women: toward an integrative model. Obstet Gynecol 1991:3-30.

14. Wesselmann U, Czakanski P. Pelvic pain: a chronic visceral pain syndrome. Curr Pain Headache Rep 2001;5:13-19.

15. National Center for Complementary and Alternative Medicine. Accessed June 2004. http://nccam.nih.gov/health/acupuncture.

Section X

Evacuation Disorders

Section X

Evacuation Disorders

Steven D.Wexner

Evacuatory disorders are very difficult to both evaluate and treat. Both urinary and fecal retention are troubling symptoms to the patients if they cannot completely void or evacuate and yet have the persistent urgency to repeatedly attempt evacuation. Patients can often spend significant parts of their lives in the bathroom seated on the commode and, between such episodes,contemplate the need to return to the bathroom.In many cases,they have such severe life-compromise that they would prefer major surgery. Because of the lack of uniform success with any of the procedures, these patients are often managed by psychologists and psychiatrists for depression. Prior psychological assessments of these patients have noted significant elevations in the "neurotic triad"including somatic sensation,hypochondriasis,and depression.As can be seen in the five chapters within this section, urinary and fecal retention is a vexing problem to which no adequate solution is universally applicable.These chapters do offer a review of the currently available therapies and discuss their anticipated rates of success and complications.

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