Although Urinary Retention is often urological in origin (e.g., prostatic hypertrophy) or a side effect of drugs (e.g., anticholinergics), it may have neurological causes. It may be a sign of acute spinal cord compression, with or without other signs in the lower limbs, or of acute cauda equina compression, for example with a central L1 disc herniation. Sometimes the level of the pathology is several segments above that expected on the basis of the ("false localizing") neurological signs. Loss of awareness of bladder fullness may lead to retention of urine with overflow.
A syndrome of Urinary Retention in young women has been described, associated with myotonic-like activity on sphincter EMG; this condition may be associated with polycystic ovary disease and is best treated with clean intermittent self-catheterization.
Fowler CJ. Investigation of the neurogenic bladder. In: Hughes RAC (ed.). Neurological Investigations. London: BMJ Publishing 1997: 397-414 Jamieson DRS, Teasdale E, Willison HJ. False localizing signs in the spinal cord. BMJ 1996; 312: 243-244