Voiding Dysfunction Symptoms Diagnosis and Treatment

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It is important to make the right diagnosis to ensure your child receives the correct treatment. For example, a man with voiding dysfunction due to an enlarged prostate might be treated with medication to ease his symptoms, rather than surgery.

Your child’s healthcare provider will do a physical exam and ask about his bladder habits. They may also request a urine test, ultrasound of the kidney and bladder and urodynamic testing.

Symptoms

Voiding dysfunction can be caused by problems involving the bladder or the tube that carries urine out of the body (urethra). These conditions may be due to a blockage in the urinary tract, muscle weakness or nerve changes. In men, it can also be the result of overactive bladder.

Symptoms of voiding dysfunction include feeling like the bladder is never fully empty, frequent urges to urinate, incontinence, leaking urine (urinary leakage), and nocturia (urinating more than six times per day). Constipation often occurs with these symptoms and can be treated with a high-fiber diet, plenty of fluids and prescription laxatives.

In addition to a physical exam, a urologist will take a urine sample and do a urinalysis to look for signs of a urinary tract infection, which can cause incontinence and urgency. Other tests can include a urethra ultrasound and a uroflow meter test to measure the strength of the urine stream.

Non-neurogenic voiding dysfunctions can be treated with medications that control the overactive bladder and pelvic floor exercises, such as Kegel exercises and biofeedback (a type of therapy that uses sensors attached to the body). For children who have a neurogenic voiding disorder, such as overactive bladder, a urologist can teach them how to use self-catheterization to help empty their bladder throughout the day.

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Diagnosis

Your bladder is a hollow muscular organ that stores urine until you’re ready to pee. A healthy bladder can move urine easily from the bladder to the tube that carries it out of your body (urethra). The urinary tract also includes the kidneys and ureters. When these parts of the body don’t work properly, it can lead to voiding dysfunction.

Voiding Dysfunction can be caused by either anatomic or neurological causes. Anatomic causes include a weak bladder muscle, a blockage in the flow of urine, or abnormal anatomy. Neurological voiding dysfunction is related to nerves that control the bladder muscles. It can occur when those nerves don’t function normally or if they are too strong. This can cause you to overfill the bladder and have a sudden urge to urinate, or it may result in urinary leakage.

To diagnose voiding dysfunction, doctors will take your child’s medical history and perform tests like a urinalysis and a quantitative urine analysis. They may order x-rays of the kidneys, ureters and bladder or a voiding cystourethrogram (VCUG). Doctors may also use uroflow testing to measure how full the bladder is after it’s been filled.

Voiding dysfunction can be caused by a variety of factors. Sometimes it is due to nerve problems affecting how the bladder muscles contract and the tube that takes urine out of the body (urethra). Other times it is related to anatomical problems, such as blockages in the urinary tract or cystitis. Some medications may also cause voiding dysfunction, including some that are used to treat anxiety or obsessive compulsive disorder (OCD).

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Treatment

Urologists Melbourne experts are highly trained in treating voiding dysfunction, including those that are caused by anatomic conditions such as an enlarged prostate or urethral strictures. In some cases, a minimally invasive surgical procedure can be needed to correct those issues and improve voiding dysfunction.

Children who have voiding dysfunction are often encouraged to keep a voiding diary to track their daytime toilet habits and identify the cause of their problem. They may be referred to a pediatric urologist for a physical exam, which includes a thorough examination of the bladder and kidneys. They may also undergo a urinalysis and bladder ultrasound to look for signs of infection or anatomical causes of the problem.

Non-neurogenic voiding dysfunction can be treated with medication such as anticholinergics, which help to relax the bladder muscles. Other medications, such as the serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta), have been shown to be helpful for both urinary incontinence and bowel dysfunction.

If your child has a voiding pattern that cannot be corrected with medicine, Health Pro offers a minimally invasive procedure called sacral neuromodulation to stimulate the tibial nerve and improve bowel function. It involves a small electrode placed in the ankle that sends gentle electrical pulses to the tibial nerve.

Prevention

Voiding dysfunction can be caused by problems with the bladder muscle or the nerves that control it. Children with voiding dysfunction have trouble relaxing or tightening the muscles when they empty their bladder. This leads to poor bladder emptying and symptoms like daytime wetting, incontinence and the feeling that the bladder is always full.

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A physical exam and a discussion of your child’s bathroom habits are the first step in diagnosing voiding dysfunction. Your doctor may also ask you to keep a voiding diary, asking your child to record every time they go to the toilet and how much urine they pass. They may also recommend an ultrasound of the kidney and bladder or urodynamic testing to measure the flow of urine.

The urinary tract includes the kidneys, ureters, bladder and urethra. The bladder muscle contracts to fill with urine and then relaxes to empty the bladder. If the muscles do not relax properly, urine can leak into areas that don’t need it, leading to voiding dysfunction.

The most common causes of voiding dysfunction are anatomical (structures of the body) and neurogenic (related to the nervous system). Conditions from birth that affect the spinal cord or brain such as spina bifida or cerebral palsy can lead to voiding dysfunction. Many children outgrow voiding dysfunction with proper treatment. However, some children continue to have frequent accidents even after they’ve been toilet trained. For these children, a procedure called sacral neuromodulation (PTNS) can be very helpful. This out-patient procedure uses a small electrode placed on the back to send electrical pulses to a nerve in the lower spine that controls bladder and bowel function.