Psychogenic dysuria

The causes of dysuria can be different, moreover, cases of psychogenic dysuria are not casuistry in general medical practice. Such patients complain of increased urination (pollakiuria), urinary incontinence (enuresis), urinary retention, or loss of urination. As a rule, for the first time, such patients turn to a pediatrician (therapist), then to a urologist who, after a comprehensive examination, excludes any organic violation of the genitourinary system. Psychogenic dysuria can be noted in the structure of general neurosis, be a somatoform disorder, or be a neurotic (usually conversion) monosymptom. Hysterical (conversion) disorders, by definition, are not simulative, but manipulative, representing either a way to draw attention to your person, which is typical for females, or being a kind of unconscious way out of a hopeless – from the patient’s point of view – situation, as it was in this case. For the same reasons, the treatment of patients with hysteria remains one of the most difficult problems, requiring the involvement of a specialized specialist – a psychotherapist or psychiatrist. Integrative psychotherapy (rational, behavioral and suggestive) is quite effective here, however, long-term treatment is usually required to achieve a good effect. Which consists of consultation with confrontational and paradoxical techniques, and the way out of such a confrontation is usually the same behavioral therapy and 5–10 sessions of hypnotherapy. The given clinical example is of scientific and practical interest, since the full effect was achieved after the first consultation and one session of hypnotic suggestive therapy.