Clinical management of bladder dysfunction caused by sexual abuse.
BACKGROUND
Victims of sexual abuse are prone to develop posttraumatic stress disorder and lower urinary tract symptoms. Conservative treatment is recommended in these patients. We reviewed the treatment results of patients in which drug treatment failed.


METHODS
In a retrospective study, results of 5 women with chronic posttraumatic stress disorder and symptoms of dysfunctional voiding were evaluated.


RESULTS
One patient was successfully treated by electrostimulation. After failure of conservative treatment, 3 patients received a sacral neuromodulator, which was revised and finally explanted in all patients. One patient received botulinum toxin-A injections in the detrusor, 2 patients underwent urinary diversion. With a follow-up of 1 year, these 2 patients are asymptomatic.


CONCLUSIONS
Although conservative treatment is recommended in these patients, surgical treatment may be inevitable in some cases. Successful surgical treatment is possible if an interdisciplinary approach with a close collaboration between psychotherapists and urologists is utilized.
Pannek
Jürgen
J
Division of Neurourology, Marienhospital Herne, Herne, Germany. juergen.pannek@paranet.ch
Einig
Eva-Maria
EM
Einig
Werner
W
D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012742:Sex Offenses; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology* / Q000628:therapy*; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000628:therapy*; D014555:Urination Disorders / Q000209:etiology* / Q000628:therapy*; D055815:Young Adult