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Objective: The pathogenesis of female urinary retention is not well known. Hence, we systematically investigated the frequency of diseases that underlie female urinary retention in a urodynamic laboratory.Methods: We analyzed data from 450 consecutive female patients. Data registries included the diagnosis, lower urinary tract symptom questionnaires, urodynamic study results, and neurologic exam observations. Complete urinary retention is defined as mean post-void residual (PVR) urine volume > 100 ml with no voluntary void at all; whereas incomplete urinary retention is defined as mean PVR urine volume > 100 ml after voluntary partial void.Results: Sixty of the 450 female patients visiting our lab (13%) had urinary retention with 4 (6.7%) of these having complete retention and 56 (93.3%) having incomplete retention. The most common underlying disease in these 60 patients was lumbar spondylosis (LS), 38.3% (with 16 patients having LS alone and 7 having LS & diabetic distal polyneuropathy [DPN]), multiple system atrophy (MSA), 18.3%, and DPN, 14.4% (with 2 patients having DPN alone and 7 having LS & DPN), followed by drug-induced retention (e.g., by antidepressants), 8.3%, acute myelitis of possible demyelinating origin, 5.0%, and other etiologies. An underactive detrusor was the major urodynamic findings in those patients.Conclusion: The present study revealed that common etiologies for female urinary retention are neurologic, e.g., an underactive detrusor due to MSA, age-related LS, and lifestyle-related DPN. Therefore LS and DPN, both common diseases, should also become major treatment targets in order to maximize patients’ quality of life.

We described a case of a young man who, after recovery from herpes simplex encephalitis with lesions in the frontal and insular cortices, developed ‘unwitting’ urinary incontinence. A urodynamics revealed 1) markedly-decreased bladder sensation and 2) a biphasic bladder disorder, e.g., before the bladder volume reaches that to provoke detrusor overactivity (DO), without bladder sensation, he is unable to contract his bladder; after provoking DO, he leaks without post-void residual. After starting clean, intermittent self-catheterization, his bladder disorder ameliorated spontaneously. This might be one form of classical ‘Andrew and Nathan type’ frontal urodynamic abnormality.