Urinary retention may develop in the absence of significant organic disease. Patients with psychogenic retention range from those with episodic acute retention to those who have learned to inhibit urination and have retention with a large residual urine volume owing to myotonic detrusor degeneration. A combination of thorough medical, neurologic, psychiatric and urologic evaluation is indicated for all such patients. Management consists of the implementation of bladder training with or without intermittent catheterization, which generally may be accomplished on an outpatient basis.