Abstract：
OBJECTIVE: Chronic Idiopathic urinary retention is poorly understood. One small study suggests higher than expected rates of functional neurological disorder and pain comorbidity which may have implications for understanding the disorder. We investigated the frequency of functional neurological disorder, chronic pain other medical and psychiatric comorbidity, triggers of urinary retention, results of urodynamic assessment, medication history, management, and outcome in patients with chronic idiopathic urinary retention.
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.
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.
摘要：
目的：对慢性特发性尿潴留了解甚少。一项小型研究表明，功能性神经系统疾病和疼痛合并症的发生率高于预期，这可能对理解这种疾病有影响。我们调查了功能性神经紊乱的发生频率,慢性疼痛，其他医学和精神病学合并症，尿潴留的诱因,尿动力学评估结果，用药史,管理,和慢性特发性尿潴留患者的结局。
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。
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。
