Psychogenic Urinary Retention in Females: Is it Real?

Introduction: Urinary retention in women is relatively rare clinical occurrence compared to men, but has a profound impact on their quality of life. It’s characterized by the inability to adequately void and empty the bladder. The underlying pathology could arise from anatomical abnormalities, neurogenic dysfunction, pharmacological or myogenic factors. Multiple studies report the concurrence of different psychological and functional disorders in women with urinary retention. This review has been done to highlight the pathophysiology, etiology, diagnostic evaluation and the approach of management of psychogenic urinary retention in females.

Methods: This paper is a narrative review of existing manuscripts regarding the psychogenic urinary retention in females. The search was done through PubMed in February 2023. The search was conducted using the following key words” psychogenic urinary retention in females”.

Results: Eighty publications were reviewed by our authors, and only 10 manuscripts were considered for this review. A classic picture of psychogenic urine retention is usually a young female, with full workup being done revealing no other causes for the retention except for psychological factors and trauma. There are many predisposing and precipitating factors for psychogenic urine retention, including perceived stress, sexual problems, and positive psychologic features. Psychogenic urine retention has attracted different therapeutic approaches and managements. Psychotherapy and other techniques like biofeedback and behavioral therapy has found to get successful outcomes. Furthermore, urethral catheterization or intermittent self-catheterization is another method of treatment. Current evidence has been reported of sacral neuromodulation demonstrating favorable outcomes in females with psychogenic urinary retention and a potential treatment option.

Conclusion: Psychogenic urine retention in females is a real disorder with distressing symptoms and complications. It should be considered after exclusion of other organic causes by thorough diagnostic measures.Early identification and intervention is crucial to help alleviate symptoms, prevent complications, and improve the patient’s quality of life. A combined multidisciplinary approach involving urologists, psychologists, and other healthcare individuals is usually the best method of management.

Keywords: Female, Management, Psychogenic, Urinary Retention.