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Psychosomatic Medicine 25:543-555 (1963)
© 1963 American Psychosomatic Society

Psychogenic Urinary Retention

Report of 6 Cases

CHARLES WILLIAM WAHL M.D.1 and JOSHUA S. GOLDEN M.D.1

1 Division of Psychosomatic Medicine, Department of Psychiatry, University of California School of Medicine, Los Angeles, Calif

Six cases of psychogenic urinary retention are described. A wide diversity of psychodynamic stresses were found to be operative in each of these cases and multiple areas of conflict relating to urogenital function were observed.

Most conspicuously present is the unconscious equation of genital with urinary function. Each case shows clear evidence of specific sexual conflicts which are consciously unacceptable. Equation of these two functions is considered to be resultant from multiple factors, among them being: (1) infantile guilt over sexual exploration, with resultant fixation of bizarre and irrational concepts of genitourinary anatomy and function; (2) identification with members of family who had previous psychosomatic urinary pathology; (3) earlier organic pathology of the genitourinary system, with resultant fixation; and (4) displacement of unacceptable sexual paraphiliac wishes. The symptoms appeared to operate as hysterical conversion reactions.

Treatment of these cases by psychotherapeutic means was uniformly successful within a short time. Office treatment and management of these problems are discussed.

Submitted on May 1, 1963






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