Psychological comorbidities and functional neurological disorders in women with idiopathic urinary retention: International Consultation on Incontinence Research Society (ICI‐RS) 2019

Abstract

Chronic urinary retention occurring in young women is poorly understood and a cause may not be found in a majority of cases. Different psychological co-morbidities and functional neurological symptom disorders (FNDs) have been reported, however these have been poorly explored. Methods: At the International Consultation on Incontinence Research Society (ICI-RS) meeting in 2019, a panel of clinicians generated a proposal to explore the relationship between psychological co-morbidities, FNDs and urinary retention in women with chronic idiopathic urinary retention. Results: Psychological co-morbidities such as depression and anxiety, and FNDs such as leg weakness and loss of consciousness, have been reported in women with idiopathic urinary retention. Individuals react differently to physical and emotional stressors, and experimental models have demonstrated a relationship between the stress response and developing urinary retention. Trauma, particularly sexual trauma, may be a shared risk factor for developing psychological co-morbidities and urinary retention. Children with voiding postponement often suffer from psychological co-morbidities and behavioral disturbances, however there is

Assessment of patients with lower urinary tract symptoms where an undiagnosed neurological disease is suspected: A report from an International Continence Society consensus working group

“…In several situations, factors affecting lower urinary tract function may be suggested by features in the medical history or physical examination: Functional neurological disorder (FND) 30 is suggested by symptoms such as limb weakness and nonepileptic attacks, particularly in women with chronic idiopathic urinary retention. FNDs may be accompanied by psychological comorbidities such as affective disorders (eg, depression and anxiety) and other functional syndromes, such as fibromyalgia or irritable bowel syndrome.…”

“…FNDs may be accompanied by psychological comorbidities such as affective disorders (eg, depression and anxiety) and other functional syndromes, such as fibromyalgia or irritable bowel syndrome. Screening tools are available for evaluating psychological/psychiatric morbidities in adults 30 …”

“…Screening tools are available for evaluating psychological/psychiatric morbidities in adults. 30 2. Centrally active medications may cause urinary retention (eg, opioids, antipsychotics, antidepressant agents, anticholinergic respiratory agents, alphaadrenoceptor agonists and benzodiazepines 31 ) or enuresis (eg, choline esterase inhibitors (such as rivastigmine or, donepezil) and antipsychotics 32 ).…”

British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction

“…Affective disorders such as depression and anxiety are the most prevalent psychological comorbidities [18]. Sexual trauma is thought to be a shared risk factor for both mental health issues and idiopathic urinary retention [19]. Specific mental health questionnaires are available to assess different problems [20], and consideration should be given early to psychological referral.…”

Urethral calculi: An uncommon but important cause of urinary retention in females

“…rinary retention is a stressful situation that requires appropriate and prompt management [1]. When it occurs, it leads to anxiety, pain and lower abdominal discomfort [1].…”