[Chronic psychogenic urinary retention]

Complete and persistent urinary retention of psychogenic origin, a syndrome standing between conversion reactions and the group of psychophysiological visceral disorders, remained an object of contradictory dispute in regard to its frequency and pathogenesis. Curiously enough, compared with other functional symptomatology, somehow this disturbance has been neglected in literature until now. Urologists, surgeons, and internists have more difficulties than psychiatrists to find out that distinct emotional conflicts and especially unsatisfactory sexual adjustment might have contributed to the development of recurrent or chronic urinary retention which they vainly tried to explain by organic findings. Of course the fact that extensive medical evaluations or even surgical procedures revealed no abnormality except the stout urinary bladder never is suifficient to qualify for "hysterical disease". Every diagnosis has to be established on positive grounds. Hypothetic explanations of mysterious syndromes by supposing more "microscopic" and thus undetected morphological deficiencies and changes as the crucial cause of a disease never should become the protective trick by which a physician avoids confrontation with his patients' psychological problems.