Objective To investigate the duration of indwelling catheter and prevention of urinary retention in patients who used PCEA after abdominal total hysterectomy through neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area. Methods 200 patients who used PCEA after abdominal total hysterectomy were randomly divided into the experimental group and the control group, each group had 100 cases. Patients in experimental group received neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, patients in control group received vitamin C injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, and removed the catheter after intervention. The time to voluntary micturition was observed, the residual urine volume was measured, prevention of urinary retention and the side effect were explored. Results The time to voluntary micturition in experimental group was shorter than in control group, there was statistically significant difference( x2 =43.8,P < 0. 01 ); the effective rate of urinary retention prevention in experimental group was 98%, and it was better than in control group which was 61%. There was statistically significant difference( x2 = 41.7 ,P <0. 01 ). No bradycardia case, no respiration inhibition case and no hypotension case in the two groups.Conclusions Necstigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area can shorten the duration of indwelling catheter in patients who used PCEA after abdominal total hysterectomy and it can prevent the incidence of urinary retention. Key words: Hysterectomy; Analgesia, epidural; Urinary Retention; Neostigmine; Nursing; Acupuncture point injection