Clinical Management of Bladder Dysfunction Caused by Sexual Abuse

Abstract

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. Patients and 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.