Psychogenic Voiding Patterns

Abstract

A urodynamic analysis was performed on 1,300 patients to precise typical psychogenic voiding patterns. Only 2.7% of this selected group showed voiding alterations derived from a psychosis or neurosis. The psychosomatic voiding alterations were to some degree similar to the alterations which were provoked by exogenous or iatrogenic influences. The voiding pattern of young children differs from that of adults when comparing psychosomatic symptoms such as prostatitis or enuresis. Urine retention and megalocystis were characteristic findings of psychotic patients whereas a polyphasic flow pattern, a delay of micturition and increased sacral reflex activity were typical findings of psychosomatic disorders. The denervation supersensitivity test is a reliable test to differentiate neurogenic from psychogenic voiding patterns.

Depression, Anxiety and the Bladder

“…The prevalence rate was almost the same as those reported in studies with similar sample sizes, e.g. 2% among 1015 urodynamic cases, 30 2.7% among 1300 urodynamic cases, 33 and 2.9% among 103 women with acute retention in a mid-sized British city. 35 As we discussed above, depression/anxiety is common in the general population, and approximately one-fourth of patients are supposed to have LUTS.…”

“…Similar episodes have been described before. 32 Toileting phobia has been reported to underlie this condition, originating from previous pain in micturition as a result of a urinary tract infection 33 or painful urological investigations. 32 However, no such histories were obtained in our patients.…”

Psychogenic urinary dysfunction: A uro‐neurological assessment

“…The results revealed PUD in 0.7% (16 cases) of our 2,300 urodynamic cases, which comprise mostly an adult population of patients in a university hospital. The prevalence rate in the present study was slightly lower than those reported in studies with similar sample sizes, for example, 2% among 1,015 adult urodynamic cases, 12 2.7% among 1,300 urodynamic cases, 14 and 2.9% among 103 women with acute retention in a midsized British city. 6 Moreover, the rate in our study was much lower than in other studies, which found a 20% incidence among urodynamic referrals and 50% within a urological practice.…”

“…Similar episodes have been described before. 17 Toileting phobia has been reported to underlie this condition, originating from previous pain in micturition as a result of a urinary tract infection 14 or painful urological investigations. 17 However, no such histories were obtained in our patients.…”

Comparison of Symptoms, Morphological, Microbiological and Urodynamic Findings in Patients with Chronic Prostatitis/Pelvic Pain Syndrome

“…A pathological urinary flow profile with decreased maximal flow rate and prolonged micturition time was equally common in all groups. This abnormality has already been described by several authors and is thought to be caused by a lack of relaxation of the bladder neck during voiding [18][19][20][21]. The common urodynamic abnormality in all groups sheds doubt on a classification into separate entities.…”