Difficulty in urination and even urinary retention in women is a clinical syndrome caused by multiple etiologies, which may be expressed by the patient: for example, difficulty in urination, or inability to urinate, or may be detected by the physician during examination, for example; incomplete bladder emptying or complete retention, and some patients may also show symptoms of the storage phase: for example, urinary frequency, urinary urgency, urge incontinence, recurrent urinary tract infections, etc. The etiology can be either bladderogenic or due to bladder outlet dysfunction, making the diagnosis and treatment of this clinical syndrome relatively difficult, so that it often leads to misdiagnosis and mistreatment. In my clinic, I often see patients with various types of dyspareunia, and one of the most common things I do is to carefully question or review the patient’s previous treatment history to determine if there is a potential for misdiagnosis or mismanagement. Here I will briefly explain the causes of this complex condition and remind you that if you have any of the following medical histories, it is important to mention them to your doctor to reduce the possibility of misdiagnosis and misdiagnosis! 1. bladder outlet obstruction dysfunction (1) anatomical obstruction: e.g. urethral stricture, primary obstruction of the bladder neck; (2) vaginal prolapse (possible urination caused by a vaginal object prolapsing outside the vaginal orifice, resulting in a folding of the urethra; (3) difficult urination after anti-incontinence surgery; (4) urethral diverticulum (typically manifested by intermittent purulent discharge from the external urethra, or palpable swelling on the anterior vaginal wall, with/without pus flow on pressure) /(5) urethral tumors (hard masses in the urethra, usually painless and bleeding, less common in such patients); (6) urethral stones; (7) functional obstruction: dysfunction of the detrusor-sphincter synergy, pelvic floor dysfunction, etc. These diseases are the most difficult to diagnose and can only be diagnosed with the help of a urologist. 2, abnormal bladder function – forceps contraction weakness (1) neurogenic – generally have a clear history of neurological disease; (2) traumatic myelopathy – clear history of trauma; (3) infectious myelopathy – have recent flu-like symptoms, generally are viral infections, sometimes as a comorbid manifestation of genital tract herpes, usually resolving with antiviral therapy and lasting 4-8 weeks, rarely becoming persistent; (4) myelopathy due to peripheral neuropathy: most typically diabetic; (5) pelvic nerve injury: seen after various radical pelvic surgeries, or large pelvic fractures; (6) myelopathy due to overfilling. (7) metabolic causes – most commonly vitamin B12 deficiency; (8) Elsberg syndrome: a meningitis-urinary retention syndrome, which can have a sacral rash; (infective polysacral radiculitis, mostly genital herpes) (9) psychogenic causes.