[The role of psychogenic factors as a cause of urinary retention in a patient with lazy bladder syndrome].
We present a child with "Lazy Bladder Syndrome". In this case psychogenic factors appeared to play an important role in the development of the voiding dysfunction in her. This factors influenced also the course of the treatment.


METHODS
A 14 years old girl admitted to Paediatric Surgery Clinic in Poznań with urine retention lasting for 20 hours. The child came of the pathologic family, and did not live with its parents. In the anamnesis: irregular mictions with episodes of urine retention. In clinical examination we found only bladder reaching the umbilicus, from which after catheterisation we got 1300 ml of urine. Antibacterial agent and observation was prescribed. After next 12 hours she passed no urine and intermittent catheterisation was started. Ultrasonography was normal. In urodynamic investigation we found in voiding cystometry: high bladder compliance, low bladder sensation with F.D. at capacity of 1000 ml. With normal relaxation in the EMG, detrusor contractions were observed neither in lying nor in sitting position. There was no pathology in the cystoscopy. Consulting neurologist found no pathology. EEG was normal. Conservative treatment with intermittent catheterisation, alfa-blocker and cisapride was continued. Consulting psychiatrist prescribed Mianserin. No spontaneous miction was observed after three weeks of this conservative treatment. The girl was sent to sanatorium, where she continued therapy. After 10 day resting in sanatorium she started spontaneous micturitions. She refused further cystometric examinations. In five consecutive uroflowmetries she passed 280 to 780 ml of urine in one portion with high flow rates.


CONCLUSIONS
1. Both functional and psychogenic factors are important in the development of "Lazy Bladder Syndrome". 2. In patients with voiding dysfunction the results of urodynamic evaluation are the most important. 3. Multispecialistic team is needed in the treatment of children with "Lazy Bladder Syndrome".
Kroll
P
P
Katedry i Kliniki Chirurgii Dzieciecej, Akademii Medycznej im. K. Marcinkowskiego w Poznaniu.
Martyński
M
M
Jankowski
A
A
D000293:Adolescent; D016241:Child of Impaired Parents / Q000523:psychology*; D005260:Female; D005581:Foster Home Care / Q000523:psychology; D006801:Humans; D016055:Urinary Retention / Q000523:psychology* / Q000534:rehabilitation