Psychogenic urinary dysfunction: A uro‐neurological assessment

Sakakibara, Ryuji; Uchiyama, Tomoyuki; Awa, Yusuke; Liu, Zhi; Yamamoto, Tatsuya; Ito, Takashi; Yamamoto, Kaori; Kinou, Mika; Yamaguchi, Chiharu; Yamanishi, T; Hattori, Takamichi

doi:10.1002/nau.20321

Cited by 28 publications

(31 citation statements)

References 32 publications

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“…Among patients visiting urology clinics because of LUTS, psychogenic bladder dysfunction (PUD) has been well documented, and includes symptoms of OAB and voiding difficulty/retention (also called paruresis or bashful bladder syndrome) . We reported on 16 PUD patients in a previous study . The age of this previous study sample was relatively young (mean 37 years [15–69 years]), which is almost the same as that in the depression cohort described above (mean 42 years).…”

Section: Lower Urinary Tract Symptom In Depression/anxietymentioning

confidence: 83%

Depression, Anxiety and the Bladder

Sakakibara

Ito

Yamamoto

et al. 2013

LUTS

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Depression and anxiety are common mental illnesses. It is recognized that depression/anxiety causes physical changes, including insomnia, anorexia, and bladder dysfunction. We aimed to delineate bladder dysfunction in patients with depression/anxiety by reviewing the literature. We performed a systematic review of the literature to identify the frequency, lower urinary tract symptoms (LUTS), urodynamic findings, putative underlying pathology, and management of bladder dysfunction in patients with depression/anxiety. From a recent survey of a depression cohort (at a psychiatry clinic), the frequency of bladder dysfunction in depression is lower (up to 25.9%) than that in Parkinson's disease (up to 75%) and stroke (up to 55%), whereas it is significantly higher than that in age-matched controls (around 10%). In both the depression cohort and the psychogenic bladder dysfunction cohort (at a urology clinic), the most common LUTS was overactive bladder (OAB), followed by difficult urination and infrequent voiding. Compared with severe LUTS, urodynamic findings were dissociated; i.e. urodynamic findings were normal except for increased bladder sensation without detrusor overactivity for OAB (50% of all patients), followed by underactive detrusor without post-void residual for difficult urination. The effectiveness of serotonergic or anti-cholinergic medication for ameliorating OAB in the patients awaits further study. In conclusion, although the frequency of LUTS among the depression cohort is not elevated, depression/anxiety is obviously a risk factor for OAB. This finding presumably reflects that the bladder is under emotional control. Amelioration of bladder dysfunction is an important target in treating patients with depression/anxiety.

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Section: Lower Urinary Tract Symptom In Depression/anxietymentioning

confidence: 83%

Depression, Anxiety and the Bladder

Sakakibara

Ito

Yamamoto

et al. 2013

LUTS

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“…The diagnosis of an underlying psychogenic aetiology as a cause of urinary retention is usually one of exclusion after a thorough investigative workup [17]. …”

Section: Discussionmentioning

confidence: 99%

A Case of Female Acute Urinary Retention Presenting to the ED

Swartzberg

Adam

Motara

et al. 2017

Case Reports in Emergency Medicine

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Introduction Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories. Case A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder. The acute retention was relieved with urethral catheterization. A Uterine leiomyoma was confirmed on histology after hysterectomy. Discussion Once the acute urinary retention has been relieved by insertion of a urethral catheter, the underlying cause of the obstruction must be determined. Although uterine leiomyoma is a fairly common finding in the general population, it is an extremely rare cause of acute urinary retention in women with just a handful of reported cases in the literature.

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“…From the classic tools of diagnosis, no conclusive organic findings could be assumed and the diagnosis was done by exclusion of the other possible causes of anuria [4, 10]. …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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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.

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Psychogenic urinary dysfunction: A uro‐neurological assessment

Cited by 28 publications

References 32 publications

Depression, Anxiety and the Bladder

Depression, Anxiety and the Bladder

A Case of Female Acute Urinary Retention Presenting to the ED

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

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