Psychosomatic aspects in urogynecology

A case report of a 46-year-old female patient with functional urinary incontinence serves to illustrate the influence of psychodynamic factors on the etiopathogenesis of this urogynecological disorder. The problems involved in the staging system devised by the International Continence Society to distinguish between stress incontinence and urge incontinence are discussed from a psychosomatic point of view and in addition differential diagnostic aspects (enuresis and female ejaculation) are considered. Furthermore, the clinical picture and pathogenesis of other psychosomatic urogynecological diseases are described, namely, in the order of decreasing involvement of psychosomatic causes: irritable bladder, chronic bladder inflammation, urinary retention, and interstitial cystitis. In conclusion, possible therapeutic measures are presented.