Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. III. Psychourological Events: 1. Psychic Anuria

Abstract

Introduction: Psychic anuria is an old term, referring to a very rare psycho-urological event that has scarcely been studied so far. Materials and Methods: A retrospective study of the patients with psychic anuria presented to Assiut Urology and Nephrology Hospital during the period July 1991–June 2016 was done. Psychic anuria was defined, and the demographic and clinical characteristics including the methods of diagnosis and management were studied. Results: Of more than 3,800 cases of anuria, 9 female patients (0.24%) experienced psychic anuria in the age range of 17–43 years. Cardinal clinical findings included anuria for 36–72 h with absence of organic causes and normal renal function tests. Psychosocial risk factors were reported in the 9 cases. Anuria was documented by reliable history (56%) or observable urine collection (44%). Diagnosis was done by exclusion, where the investigations revealed no organic causes. Seven cases responded to the placebo intervention and 2 cases were self-limiting and resolved spontaneously. Conclusions: Psychic anuria is an extremely rare urological emergency that presents, mainly, in young adult females with unknown mechanisms. Renal vasoconstriction following psychosocial stressors is suggested. It is diagnosed by exclusion and resolves spontaneously or responds to placebo intervention as a mental distraction technique.

Experience of a tertiary-level urology center in the clinical urological events of rare and very rare incidence. III. Psychourological events: 2. Phobia of renal failure due to loin pain

“…The low socioeconomic characteristics played a role in alteration of ESRD risk perception, when they were linked to loin pain. Similar forms of psychosomatic presentations of renal disorders could be found in the literature such as the loin pain hematuria syndrome and psychic anuria [12,27]. Clinical characterization of flank or loin pain in the emergency departments according to strict guidelines or approaches seems to be heterogeneous due to the individual propensity and expertise.…”