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Bladder colic and pregnant dysuria refers to the condition during the seventh or eighth month of pregnancy where the bladder is compressed, leading to difficulty in urination.

This condition, Jingui Yaolue refers to as "bladder colic and pregnant dysuria," Jiayi Jing calls it "胞轉," Zhubing Yuanhou Lun describes it as "pregnancy with difficulty in urination," the annotated Furen Liangfang terms it "轉脬," and Bencao Gangmu labels it "pregnancy with difficult urination."

This condition shares similarities with strangury during pregnancy in symptoms and signs but also has differences. As stated in "Zhengzhi Yaojue": "Strangury during pregnancy is similar to bladder colic and pregnant dysuria, but frequent urination with dripping and pain indicates strangury during pregnancy; frequent urination with little output and no pain indicates bladder colic and pregnant dysuria, with occasional mild pain, ultimately differing from strangury." This illustrates that the presence or absence of pain is the main distinction between the two.

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1. Spleen Deficiency︰During the seventh and eighth months of pregnancy, difficulty in urination or frequent urination with scant output, lower abdominal distension and fullness, and urgency. Palpitation, shortness of breath, mental fatigue, lack of strength, heaviness of the head, and dizzy vision. Pale tongue with thin coating, weak and slow yet slippery pulse. The fetus resides in the mother's womb, relying on qi to support it. Nyuke Jinglun quotes Zhao Yang-kui as saying: "Due to deficiency and timidity of middle qi, it fails to lift the fetus, which then presses on the bladder, twisting its connections, leading to difficulty in urination." Clinical manifestations include inability to urinate or very scant urination, lower abdominal distension and fullness, urgency, and restlessness whether sitting or lying down. Accompanied by a pale complexion, palpitation, shortness of breath, mental fatigue, lack of strength, heaviness of the head, dizzy vision, pale tongue, and weak pulse—all signs of spleen deficiency. Treatment should focus on tonifying qi, raising the sunken, and lifting the fetus. The recommended formula is the Qi-Tonifying and Urination-Promoting Decoction, or Middle-Tonifying Qi-Replenishing Decoction with added Poria and Plantain Seed. For cases of dual deficiency of qi and blood, treatment should additionally nourish blood, using the Fetus-Lifting Four Ingredients Decoction with added Lindera.
2. Kidney Deficiency︰Pregnancy late stage [third stage], frequent urination, dribbling and difficult urination, followed by complete retention, lower abdominal distension and fullness with urgency. Edema in the limbs, dull complexion, physical fatigue and fear of cold, dizziness, soreness and weakness in the waist and legs. Pale tongue texture with thin white moist coating, deep slow or deep slippery and weak pulse. The fetus is connected to the kidneys. If the pregnant woman has inherent weakness and kidney deficiency fails to support the fetus properly, the fetus compresses the bladder, causing the bladder's qi transformation function to malfunction, resulting in dribbling urination or complete retention, with lower abdominal distension, fullness, and urgent pain. Often accompanied by symptoms of kidney yang deficiency such as dull complexion, edema in the limbs, physical fatigue and fear of cold, soreness and weakness in the waist and legs, and deep pulse. The treatment should focus on tonifying the kidneys and warming yang, warming yang qi to promote diuresis, using the modified Kidney Qi Pill.
3. Qi Depression︰During the seventh or eighth month of pregnancy, there is a sudden inability to urinate, accompanied by lower abdominal distension and fullness, as well as urgency and pain. There may also be chest tightness, hypochondriac distension, irritability, and a tendency to sigh. The tongue coating is normal, and the pulse is deep, wiry, and slippery. This condition is often caused by excessive worry or anger, leading to qi depression and internal retention of water-dampness, which results in the twisting of the bladder system and subsequent urinary obstruction, along with lower abdominal distension, fullness, and urgency. The key diagnostic points are: sudden inability to urinate, accompanied by symptoms of qi depression such as chest tightness, hypochondriac distension, irritability, and a deep, wiry, slippery pulse. The treatment principle is to regulate qi and promote water metabolism, using Amber Powder with the addition of Lindera.
4. Heat Accumulation︰Pregnancy late stage [third stage], scanty and dark urine, followed by urinary retention, lower abdominal distension, normal appetite, heaviness of head with dizziness and distension, dry stool, or diarrhea with incomplete evacuation. Tongue texture red with yellow and greasy coating, pulse slippery and rapid. Mostly caused by dampness-heat in lower energizer accumulating in the bladder, or heat in the small intestine transferring to the bladder. Taiping Shenghui Fang states in "Treatments for Women's Bladder Distortion": "When the bladder is oppressed by heat, or when urination is forcibly withheld, both conditions cause water qi to press upon the bladder, bending and preventing it from fully expanding. External fluids that should enter cannot enter, and internal urine that should exit cannot exit. Internal and external stagnation leads to distension and obstruction, hence bladder distortion." The key diagnostic points are: scanty and dark urine progressing to complete obstruction, with normal appetite. As Zhangshi Yitong mentions in the Women's Section: "This difficulty in urination results from bladder heat stagnation, qi congealing into dryness, with the disease located in the lower energizer, hence the normal appetite." Accompanied by manifestations of dampness-heat stagnation such as heaviness of head with dizziness and distension, chest oppression and irritability, dry stool or diarrhea with incomplete evacuation, yellow greasy tongue coating, and slippery rapid pulse. Treatment should focus on clearing heat and draining dampness, using Angelica, Fritillary and Sophora Pill or Qing Pao Yin. If there is chest stuffiness and oppression, heaviness of head with pain, white greasy tongue coating, and soggy pulse, this indicates excessive dampness. Treatment should emphasize drying dampness and promoting water movement, using Five Ingredients with Poria Powder plus Plantain Seed.

Ancient people believed that bladder colic and dysuria during pregnancy were caused by fetal pressure on the bladder and abnormal tension of the uterine ligaments. Differentiation of syndromes should distinguish between deficiency and excess. During treatment, one should not rigidly adhere to the symptom of urinary retention and indiscriminately use diuretics. If urinary retention persists for a long time and is accompanied by severe abdominal distension and pain, catheterization should be promptly employed.

bubble_chart Documentation

1. Danxi Xinfa．Lin: "The syndrome of bladder torsion is characterized by acute pain below the navel and difficulty in urination. It is often caused by forcibly holding in urine, or rushing to urinate, or eating a full meal and then holding in urine, or eating a full meal and then riding a horse, or holding in urine and then engaging in sexual activity, which causes the rising of qi to reverse, and the qi to press against the bladder, thus bending and twisting it so that it cannot relax. If the bladder falls, death ensues."
2. Yixue Xinwu．Women's Section: "However, there are also cases where yang is excessive and yin is diminished, where solitary yang has no yin, and where the small can transform qi. In such cases, it is necessary to supplement the true yin. Ancient prescriptions used Kidney-Nourishing Pill, and I have often used the Six-Ingredient Pill with Plantago and Achyranthes Root, achieving success. ... Generally, if the right chi is excessively strong and the left chi is weak, and the pulse is thin, rapid, and weak, it indicates water deficiency; if the left chi is excessively strong and the right chi is weak, and the pulse is large, weak, and weak, it indicates true fire deficiency. Those with fire deficiency experience pudendal coldness in the abdomen, prefer heat, fear cold, and have dribbling, clear urine; those with water deficiency experience vexing heat in the abdomen, prefer cold, fear heat, and have urine that dribbles out like Phelloendron Bark."