Psychogenic urinary retention in women.

There appears to be a spectrum of psychogenic urinary retention that is seen mostly in women. The degrees of psychiatric disorder and bladder disorder do not necessarily coincide. Some patients with psychogenic retention may have one acute episode temporally related to psychologic trauma. Others may present with problems related to large residual volumes such as recurrent urinary tract infection or incontinence. All patients require complete neurologic, urologic, and psychiatric evaluation. Permanent urethral catheterization is avoided if possible. Intermittent self-catheterization should be used during periods of psychotherapy and bladder training. Patients with neurogenic bladder, as determined by urodynamic studies, should be managed by bladder training and the use of pharmacologic agents when indicated.