Psychogenic retention of urine

Psychogenic retention of urine (PRU) may manifest itself in different clinical forms which mimic a genuine organic disturbance. Three clinical examples are presented in which PRU appears as: (1) malingering; (2) an upper motor lesion inducing spastic closure of the bladder neck, and (3) an alteration of the sensory input, closely resembling sensory neuron damage. The urologist becomes involved in the treatment of these patients by the natural expression of the symptoms. The underlying psychogenic factor does not become evident until urodynamic investigations and often specific therapeutic steps have been undertaken. The urologic treatment sometimes appears helpful because the patients do not realise or refuse to accept the idea of a psychogenic cause and expect relief from the urologist. The latter should withdraw his involvement as soon as an organic cause has been excluded.