Acupuncture in Genitourinary & Related Conditions
2c. Summary of Points & Protocols for Male Disorders

ANDROPATHIES
Problems of male reproductive and sexual function, including impotence, can be due to psychological / emotional / mental inhibition . (See the importance of the emotions in TCM ). Counselling, hypnosis & visualisation can be important in therapy of such cases. As well as addressing any imbalance of Qi or Xue in the Channels or Vessels, etc (see later), TCM treatment of impotence would address any psychological / emotional / spiritual causes, possibly using the related Spirit Points.

In sexual disorders, choose points on CV, GV, BL, LV, KI, SP Channels (most authors) & on PC, HT, LU Channels ( 391 ). Taking all 48 sets of data (Refs. 27 , 46 , 58 , 63 , 78 , 90 , 98 , 107 , 108 , 131 , 154 , 160 , 162 , 179 , 184 , 185 , 199 , 200 , 207 , 211 , 212 , 235 , 247 , 248 , 250 , 251 , 265 , 282 , 289 , 292 , 296 , 315 , 326 , 328 , 336 , 341 , 344 , 345 , 346 , 350 , 364 , 369 , 377 , 391 , 401 , 402 , 404 , 412 , 415 ), the acupoints (with number of Citations) used were: 

No. of Citations
18-22
10-15
6-9
3-5

1-2

Acupoints in andropathies, from amalgamation of data [ 48 Data Sets ]
BL23, BL32, CV04, SP06 
CV01, CV03, GV04, ST36 
BL31, BL33, BL34, CV02, CV06, KI03, KI12
BL28, BL54, GV03, KI02, KI06, KI07, LV01, LV02, LV03, LV11, SP09, ST29, ST30, Tianying (the Lesion)
Animal-Baihui, Ashi, BL10, BL14, BL15, BL19, BL27, BL29-1, BL30, BL35, BL43, BL52, BL53, BL55, CV05, CV07, CV08, CV10, CV17, GB27, GB34, GV01, GV02, GV20, HT07, K112, KI04, KI08, KI10, KI11, KI23, LV04, LV06, LV08, LV12, PC06, PC09, Prostate-Point, SP04, SP08, SP12, ST44, TH05, X_29, Y_13, Y_14, Y_15, Y_18 

Of 10 papers that reported use of Earpoints in Andrology / Urology, frequency of Citation was: 

6-7
2-3
1

BL, KI, Shenmen 
Brain, Endocrine, HT, LU, SP, Subcortex, Sympathetic, Ureter, Urethra 
Adrenal, LV, SI, Support, TH, Yiniao-Enuresis

Three protocols to treat andropathies, using CV02 or CV04 +/- SP05 only:

• CV04 & SP06 (131)
• Lie patient face-up; insert 2 long (3.5") needles vertically at Y_14-Yijing (Spermatorrhoea, 1" lateral to CV04); twist & advance needles obliquely towards midline to depth of 2.5-3" until Deqi comes. (315)
  
• Patient must empty bladder. Insert 3-4" needle at CV02 straight into the skin & subcutaneous tissues, then angle forward obliquely at 45-60 degrees, slowly, into space between pubic symphysis & bladder. Advance slowly until clear resistance occurs when tip is circa 3" deep. Get strong Deqi by slow gentle thrusting & rotating of small amplitude. (336)

MALE INFERTILITY, SPERMATOPATHY, ABNORMALITIES OF SPERM COUNT OR QUALITY 
Spermatopathy includes oligospermia, aspermia, poor sperm motility, deformed sperms, prolonged liquefiable time of semen.

No. of Citations

6-10
4-5
2-3
1

Acupoints in Male infertility, spermatopathy, abnormalities of sperm count or quality [ 11 Data Sets ]
BL23, BL32, CV04, SP06 
BL33, CV03, GV04, KI03
BL31, BL34, CV02, CV06, KI06, KI12, ST36
BL27, BL28, BL52, CV01, GV01, GV03, KI02, KI07, KI11, LV02, LV03, SP08, SP09, ST29, ST30, Y_13, Y_15, Y_18

Protocols to Treat Spermatopathy & Male Infertility

• Every 2 d for 7-10 times/course, AP 5 points from KI12, CV02, CV03, CV04, KI11, BL32, BL33, LV02, LV03, or inject 10 ml 0.5% procaine at 2 points from BL23, BL27, BL28, BL31-34. (179)
• AP + ginger-padded moxibustion at two point-groups: (1) AP KI12, CV02, SP06 + moxa at CV04, CV03; (2) AP BL31-34, BL23 + moxa at BL23, GV04. Get Deqi with the needles; then use 3 moxas at most. Alternate every 2d, 5 times/course; repear course after 1 wk if sperm test is not more normal then. (184)
• AP (with Bu Fa - reinforcing method) + ginger-padded moxibustion. After AP & Deqi, use 3 cones of moxa at GV04, BL23, CV04, CV03, divided into two groups & used alternately. (185)
• AP BL23, CV04, GV03, KI02, KI07, ST36, SP06, etc. (200)
• BL23, SP06, BL32, CV04, CV03 +/- Y_13, Y_15, Y_18, ST29, BL31, BL33 (247)
• AP CV04, CV03, KI03, KI06 with even manipulation to get Deqi. Retain needles & use warming-needle technique (2-3 moxa cones). Then moxa & massage CV01 alternately for about 30 min. Treat once/2 d, 10 times/course, with 6 d between courses. (292)
• AP KI06, KI03; SP06, SP08, SP09; ST36; CV06, CV04, BL23, BL52, split into two groups & alternate every 1-2 d until d 21; repeat course after 7-10 d interval; get Deqi to penis/scrotum from the CV points; retain 15-20 min. (344)
• GV01, GV04, BL23. Inject mixture of Vit B1 (2 ml) & Vit B12 (2ml), 1 ml/point. (350)
• KI Xu: AP +/ moxa at BL23, BL32; Abnormality of CV & GV: AP CV04, ST30, 1.5-2"; get Deqi to the glans penis. (401)
  
• AP CV06, CV04, SP06, BL23, BL32, KI03 +/- other points according to TCM types. Results not as good in prostatitis as in those with simple spermatopathy) (402)
• Treat once/d with 5 cones of ginger-padded moxa at CV04 + KI03 (or GV04 + BL23) + AP SP06 (or KI03). Retain 30 min. Alternate the groups every 5 d, 10 times/course, 17-24 courses. Add herbal medicine. (415)

DISORDERS OF EJACULATION
Ejaculatory disorders include premature emission, prospermia, weak ejaculation, retrograde ejaculation, involuntary urination during intercourse, & spermatorrheoa or involuntary loss of semen. Points for involuntary seminal emission are similar to those for enuresis & urinary incontinence.

No. of Citations
5-7
3-4
1-2

Acupoints in Disorders of ejaculation [ 9 Data Sets ] 
BL23, BL32, CV03
BL33, CV04, SP06, SP09
BL27, BL28, BL31, BL34, BL54, CV01, CV02, CV06, CV08, GV04, KI03, KI11, KI12, LV01, LV02, LV03, LV11, ST30, ST36 ST44

Protocols to Treat Ejaculation Disorders
Ejaculation dysfunction

• Every 2 d for 7-10 times/course, AP 5 points from KI12, CV02, CV03, CV04, KI11, BL32, BL33, LV02, LV03, or inject 10 ml 0.5% procaine at 2 points from BL23, BL27, BL28, BL31-34. (179)
  
• AP CV03 + ginger moxa at CV04, or AP BL23, BL32, BL34 + moxa at GV04. Alternate these points for 15 times/course. (200)
  
• AP CV01 to 1.5-2" deep; in KI Xu add KI03, ST36; in Damp-Heat attack of Lower Jiao add SP09 + ST44. Manipulation: Puncture CV01 1.5-2" deep; then twist & rotate. Retain 20-30 min; manipulate every 5-7 min. Treat every 1-2 d. (212)
• SP06, CV04, BL23, CV03, CV06, BL32, GV04 +/- BL33, BL31, ST36 (248)
• AP BL54 (296)
• CV03, SP06, BL23, BL32, BL28 (364)
  
• CV01, CV03, CV06, SP06, SP09 (369)
• AP BL23, BL32, CV04, ST30, SP06, LV03, SP09 (401)
  
• AP CV02, BL32, LV11 + moxa at LV01, CV08 every 2-3 d, 10 times/course. Cases need 3-47 times. (404)

DISORDERS OF THE PENIS, URETHRA, SEX DRIVE, MALE IMPOTENCE, ERECTILE DYSFUNCTION
Impotence can be due to psychological / emotional / mental inhibition . (See the importance of the emotions in TCM ). However, potent males can become temporarily or chronically impotent in physical disorders , such as in weak Qi of the KI, SP, LV, CV or GV in advancing age, in prostatitis, testicular pathology, post-castration. Also, impotence may arise secondary to pain, trauma or nerve dysfunction (general, lowback, or in the genitalia; multiple sclerosis, diabetes etc), or as side effects of chemotherapy or medication. AP can be very helpful in treating these disorders.

No. of Citations

5-7
2-4

1

Acupoints in disorders of the penis, urethra, sex drive, male impotence, erectile dysfunction [ 13 Data Sets ]
BL23, BL32, CV02, CV04, ST36
BL28, BL31, BL33, BL34, CV01, CV03, CV06, GV03, GV04, KI03, KI07, KI12, LV01, LV02, LV08, LV11, SP06, SP09
BL10, BL27, BL52, BL53, BL54, CV05, CV07, CV08, GV01, GV02, GV20, HT07, KI02, KI06, KI10, KI11, KI23, LV03, LV04, LV12, PC06, PC09, ST30; Earpoints HT, KI, LV

Protocols to Treat Disorders of the Penis, Urethra, Sex Drive, Male Impotence, Erectile Dysfunction
Impotence

• Patient must empty bladder . Needle CV04->CV03 for 2.5"; reinforce to get Deqi to glans penis. Needle SP06 to 1" deep; reinforce-reduce evenly. Reinforce (twist-rotate) at BL23. Needle BL32 to 3-4" deep to get Deqi to perineum & genitals. Treat once/d, 7 times/course. Injection is better: Treat CV04, SP06 as above; Mix 31 ml of 5% glucose solution with 1 ampoule (2 mg/ml) of strychnine nitrate. Inject 4 ml of mix/point at BL31, BL32, BL33, BL34, bilateral. Treat once every 2 d, 3 times/course. Allow 7 d between courses. (162)
• Lie patient face-up, relax body, dispel distractions & enter a quiet state. Insert 2" needles at CV04, CV03 or CV02 + KI12, with the tips pointing to the perineum. Lift, thrus & twirl to get Deqi to penis & prepuce. With patient face-down, AP BL32 to get Deqi to perineum or penis. Add BL23 & GV04 +/- ST36, SP06 & KI03. Treat once/d, 10 times/course. (199)
  
• Insert 3" 28 gauge needle at BL29-1 (0.5" lateral to BL29) at 60 deg to the skin inferiorly through gluteus maximus & greater sciatic foramen; get heavy & tense feeling under the tip of needle. Continue to rotate until Deqi goes to lower abdomen & perineum. Retain 20-25 min. (412)
  

Penis, urethra, sex drive, male impotence, erectile dysfunction

• EAP at bilateral ST36 increased testosterone (T) + DHT levels in experimental rats, even in castrated rats (T also comes from adrenal). (154)
• AP 3-12 times at GV03, GV02, BL10, BL28, BL23, PC09, KI03, KI12, KI23, ST36, SP06, LV02, LV08, CV03, CV04, CV05, CV06, etc. with reinforcing manipulation. (160)
  
• Every 2 d for 7-10 times/course, AP 5 points from KI12, CV02, CV03, CV04, KI11, BL32, BL33, LV02, LV03, or inject 10 ml 0.5% procaine at 2 points from BL23, BL27, BL28, BL31-34. (179)
• AP BL23, CV04, GV03, KI02, KI07, ST36, SP06, etc. (200)
• Penis / urethra / impotence: CV04, SP06, BL23, CV03, BL32, CV06 +/- BL28, BL31, BL33, BL34, BL52, CV01, CV02, CV07, GV03, GV04, HT07, KI10, KI12, LV01, LV02, LV04, LV08, LV12, SP09, ST36; Satyriasis: KI06, SP06, BL23, BL53, BL54, LV02, CV03, CV04, CV07 (247)
  
• AP BL23, GV04, bilateral KI07, CV04; reinforce. After Deqi, twist & twirl. Needle CV04 obliquely for 2-4" with 5" 28 gauge needle at angle of 45 degrees until Deqi goes to glans penis; twist, twirl, lift & thrust for 5 min. Combine with AP +/- EAP Earpoints KI, LV, bilateral HT; reinforce; retain 30 min. Treat every 2 d, 1-2 sessions/course, 1-3 courses. (282)
  
• Lie patient face-up; insert 2 long (3.5") needles vertically at Y_14-Yijing (Spermatorrhoea, 1" lateral to CV04); twist & advance needles obliquely towards midline to depth of 2.5-3" until Deqi comes. (315)
• AP via 2.5" needle was used once every 2-3 days for 10 times/course at BL32, CV02, LV11, LV01. Insomnia: add GV20, PC06; General weakness, anorexia & constipation: add ST36. Get Deqi at BL32, LV11. While needling CV02 aim to induce an electric shock sensation radiating to the base of the urethra. Throughout therapy, moxa was used 1-2 times/d at LV01 for 5 min, using the bird-pecking method. (328)
• Patient must empty bladder. Insert 3-4" needle at CV02 straight into the skin & subcutaneous tissues, then angle forward obliquely at 45-60 degrees, slowly, into space between pubic symphysis & bladder. Advance slowly until clear resistance occurs when tip is circa 3" deep. Get strong Deqi by slow gentle thrusting & rotating of small amplitude (336)
• GV01, GV04, BL23. Inject mixture of Vit B1 (2 ml) & Vit B12 (2ml), 1 ml/point. (350)
• CV01, CV03, CV06, SP06, SP09 (369)
  
• AP BL23, BL32, CV04, ST30, ST36, KI03. (401)
• AP CV02, BL32, LV11 + moxa at LV01, CV08 every 2-3 d, 10 times/course. Cases need 3-47 times. (404)
  

DISORDERS OF THE TESTICLE

No. of Citations
4
3
2
1

Acupoints in Testicular disorders [ 8 Data Sets ] 
SP06
BL23, CV04, ST29, ST36
BL32, CV03, KI08, KI12, ST30
BL14, BL15, BL19, BL31, BL33, BL34, BL43, CV01, CV10, CV17, GB27, GB34, GV20, KI02, KI07, LV01, LV03, LV06, LV11, LV12, PC06, SP04, SP12; Earpoints Adrenal, Endocrine, HT, Subcortex, Sympathetic, SI

Protocols to Treat Testicular Disorders
Epididymal stasis after vasoligation

• Audio-frequency stimulation via 50x15x1 mm electrodes; two protocols were used once/d, 10 d/course: (a) In Course 1, two electrodes at bilateral ST30-LV12-LV11 (200 Hz, 20 mA); (b) In Course 2, two electrodes CV01 + CV03-K112 (200 Hz, 20-30 mA). Protocols (a) & (b) were alternated between courses. In Course 3, maximal intensity was <40 mA. (63)

Male Deficiency

• Yang Xu: Use AP at BL23, BL32, CV04, ST30 + moxa at CV10. Treat for 20 d, with 1 wk interval before next course. Yin Xu: Use AP (not moxa) at BL23, BL32, CV04, ST30 (401)

Male hypogonadism

• AP once/d at PC06, ST36, BL15, BL43 +/- SP06, CV17, BL14, BL19, GV20 according to symptoms, + Vaccaria Seeds at Earpoints Adrenal, Endocrine, HT, Subcortex, Sympathetic, SI; press daily. This raised testosterone & reduced oestrogen in plasma of male CHD cases. (289)

Male hypogonadism, lack of aggression

• EAP at bilateral ST36 increased testosterone (T) + DHT levels in experimental rats, even in castrated rats (T also comes from adrenal). (154)

Testicle pain & swelling in mumps

• LV03 + SP06 (235)

Testicle pain after trauma

• AP LV01, KI02, ST36, CV04, ST29, BL23. Pain gone after 3 times. (345)

Testicle, orchitis, pain, swelling 

• SP06, ST29, BL32, BL31, BL33 +/- BL34, KI07, GB27, SP12, KI08 (247)

Testicle, trauma

•      SP06, KI08, KI12, GB34, SP04 +/- BL23, CV03, CV04, LV06, ST29 (247)

DISORDERS OF THE PROSTATE
Prostatic disorders include prostatitis, prostatomegaly, prostatic hypertrophy, hyperplasia & pain. Prostatitis in TCM is due to SP Qi Xu + KI Qi Xu, with Xue Stasis & downward flow of Damp-Heat to Lower Jiao. It manifests as frequent & urgent urination, lumbosacral ache, heavy & distending sensation of lower abdomen, prostatic pain etc. TCM treatment (AP + drugs) aims to reinforce SP & KI, eliminate Damp & Heat, & activate the blood to remove Xue Stasis, i.e. to decongest the affected area (J Fujian Coll Trait Chin Med 3 (3):129-131). 

No. of Citations
6-8
3-5
1-2

Acupoints in prostatic disorders [ 21 Data Sets ] 
BL23, BL32, CV01, SP06
BL30, BL35, BL54, CV03, CV04, GV04, ST29
Animal Baihui, BL28, BL31, BL33, BL55, CV02, CV06, GB34, GV01, KI02, KI04, KI06, KI12, SP09, ST36, X_29

Protocols to Treat Prostatic Disorders

• Red hot fire needle was used at KI02, BL55, SP06. (27)
  
• Laser-AP gave better cure rate than simple AP (83% vs 52% ). AP at BL32 or BL30 had similar efficacy to AP at the classic "Prostate Point" (CV01). AP at BL32, BL30 is easy, safe & causes less suffering than AP at CV01; however AP at CV01 may be better when prostatitis is marked by pain in the perineum. (46)
• Laser-AP via a 50-125 um optical fibre in a needle inserted into the prostate from CV01. Treat for 20 min once/d, 4 times/course. (58)
• AP BL35, BL23; reduce strongly; do not retain. Treat every 1-2 d, 10 times/course. (90)
• Moxa at BL23, CV04, or add KI06, ST36, SP06. (98)
• Insert AP needle, 28 gauge, 3-4", perpendicularly1.5-2" at new "Prostate Point" (midway between CV01 & the anus). Reduce (lift & thrust in a small range 2-3 times, or twist & rotate); retain 20 min. Treat once/d, 10 d/course. (107)
• Strong AP at BL32 + CV03 once/d, 10 times/course, with 2-3 d between courses (108)
  
• AP BL54 + SP06 (207)
• Laser-AP + Injection of Shuang Huanglian into the Gland (? via CV01). (211)
• SP06, CV04, CV03, BL23, BL28, SP09, ST29 (247)
• EAP (3 Hz) at KI12, SP06, BL23, BL32 (bilateral) + sensitive points of pudendum. for 10 min, then bird-pecking technique on tender points on the perineum. Treat once/wk for 10 times. (250)
• EAP at 0.5-50 Hz via AP needles in the epidural space at GV04 & caudal (? Lumbosacral) space (251)
  
• AP BL54 bilateral; retain needles for 20 min. Then use spear- & hooked- needle to cut GV04, Yaoqi (X_29-Lower Back 'Miscellany', in GV line between left & right BL32) & BL31-34. Treat daily until improved. (265)
  
• AP once/d at CV04, BL23 (bilateral), BL31 (bilateral) (326)
• Patient must empty bladder. Insert 3-4" needle at CV02 straight into the skin & subcutaneous tissues, then angle forward obliquely at 45-60 degrees, slowly, into space between pubic symphysis & bladder. Advance slowly until clear resistance occurs when tip is circa 3" deep. Get strong Deqi by slow gentle thrusting & rotating of small amplitude (336)
• AP BL35 + BL23 was better than at other points such as CV04, CV03, GB34 + SP06. AP BL35 may stimulate pelvic plexus to regulate prostatic blood circulation. (341)
• Laser-AP via optical fibre in cannula inserted 1-4 cm at "Prostate point" (CV01), BL30, BL32, etc. Retain 10-30min. Treat QD or QOD, 4-5 points/time, 10 times/course, 2 courses. (346)
• GV01, GV04, BL23. Inject mixture of Vit B1 (2 ml) & Vit B12 (2ml), 1 ml/point. (350)
• AP (needle 5-7", 30 gauge) slowly from from BL54 or CV01 to ST29 with patient on side with knee flexed. Deqi should radiate to urethra at depth of 5-6". Then AP CV06, CV03, ST29, CV04 perpendicularly to a depth of 3-4"; make Deqi spread down to urethra (369)
• Laser-AP via optical fibre, 80 um via cannula at CV01 penetrating into the prostate (377)
• KI04, TH05 (391)

Phil Rogers MRCVS, Lucan, Dublin, Ireland​
THE NYCAVMA IS HONORED TO HOST & MANAGE THE PHIL ROGERS ARCHIVE