[Psychosomatic aspects of irritable bladder. A review].

Nervous bladder symptoms without any established organic causes would appear to be a psychosomatic illness that usually affects married women in midlife. The majority of these patients manifest serious neurotic disorders such as anxiety neurosis, hysteria, phobia, and depression or larvate depression. It is often possible to identify psychosexual disorders in these patients. The predominant situations that seem to trigger irritable bladder symptoms are: sexual intercourse that ends unsatisfactorily for physical or psychological reasons, a partnership conflict, or even a separation conflict. Patients with a hysterical personality structure who are dominated by Oedipus or phallic problems and who, by inhibiting the sexual impulse, frequently suffer from sexual disorders may, in a situation experienced in such an atmosphere of conflict, regress to the stage of urethral erotism; at this stage, the symptoms serve as self-punishment as well as reduction of the fear of guilt and punishment; the unconscious vexation and frustration manifest themselves in these symptoms. In the case of depressive patients, unconscious anger and helplessness can be manifested as irritable bladder symptoms. As a result of the close connection between these urinary disorders and sexual disorders, irritable bladder symptoms without any established organic causes would appear not to be a urological but rather a covert functional sexual disorder.