METHODS: A consecutive retrospective electronic notes analysis was undertaken of patients with chronic idiopathic urinary retention presenting to a secondary care urology clinic between Jan 2018-Jan 2021, with follow-up to their most recent urological appointment.
RESULTS: 102 patients were identified (mean age of 41.9 years, 98% female). 25% had functional neurological disorder (n = 26), most commonly limb weakness (n = 19, 19%) and functional seizures (n = 16, 16%). Chronic pain (n = 58, 57%) was a common comorbidity. Surgical and medical riggers to urinary retention were found in almost half of patients (n = 49, 48%). 81% of patients underwent urodynamic assessment (n = 83). Most frequently no specific abnormality was reported (n = 30, 29%). Hypertonic urethral sphincter was the most identified urodynamic abnormality (n = 17, 17%). We noted high levels of opioid (n = 50, 49%) and benzodiazepine (n = 27, 26%) use. Urinary retention resolved in only a small number of patients (n = 6, 6%, median follow up 54 months), in three cases spontaneously.
CONCLUSIONS: This preliminary data suggests idiopathic urinary retention is commonly comorbid with functional neurological disorder, and chronic pain, suggesting shared mechanisms.
方法:对2018年1月至2021年1月期间到二级护理泌尿科诊所就诊的慢性特发性尿潴留患者进行了连续的回顾性电子笔记分析,并对他们最近的泌尿科预约进行了随访。
结果:确定了102例患者(平均年龄41.9岁,98%女性)。25%患有功能性神经系统疾病(n=26),最常见的是肢体无力(n=19,19%)和功能性癫痫发作(n=16,16%)。慢性疼痛(n=58,57%)是常见的合并症。在几乎一半的患者(n=49,48%)中发现了尿潴留的手术和医疗设备。81%的患者接受了尿动力学评估(n=83)。最常见的是没有具体的异常报告(n=30,29%)。高渗尿道括约肌是最确定的尿动力学异常(n=17,17%)。我们注意到高水平的阿片类药物(n=50,49%)和苯二氮卓(n=27,26%)的使用。尿潴留仅在少数患者中解决(n=6,6%,中位随访54个月),在三种情况下自发地。
结论:该初步数据表明特发性尿潴留通常与功能性神经系统疾病并存,和慢性疼痛,建议共享机制。