Voiding Dysfunction

What are the signs and symptoms of voiding dysfunction?

Symptoms include daytime wetting or leaking of urine, nighttime wetting when previously dry, recurrent urinary tract infections, pain with voiding without evidence of a urinary tract infection, urinary urgency, urinary frequency, stopping and starting urine flow and/or straining to void or hesitancy to void.

What tests are used to diagnose voiding dysfunction?

A child must be potty trained in order to diagnose dysfunctional voiding. Often uroflow tests and bladder scan are performed to diagnose dysfunctional voiding.

The uroflow is a test that provides information about the urine flow and how the bladder and sphincter muscle work together. The test simply requires that your child voids into a special toilet.

A bladder scan, performed after the uroflow, evaluates the amount of urine left in the bladder after voiding. An abdominal X-ray may also be performed to identify any stool burden contributing to the condition. Further evaluation of the urinary tract is done on an individual patient basis.

How do doctors at Children's Colorado make a diagnosis?

A voiding diary can be very useful for identifying voiding dysfunction. This should include how often and how much your child is voiding. Filling out a list of fluid intake over several days (called an intake diary) can also be helpful. This information allows your child's healthcare provider to more clearly understand your child's habits and to diagnose the cause of their symptoms.

How is voiding dysfunction treated?

Treatment usually begins with placing your child on a strict bowel and bladder program to establish a timed voiding schedule. This means that the bladder should be emptied before the urge to go to the bathroom. Every two hours during the day is a good place to begin. The goal of a voiding schedule is to break old habits and learn healthy ones. The new habits allow control and consistent emptying of the bladder.

Constipation can also play a role in voiding dysfunction, so it's always important to ensure good fiber intake and daily stools. Some children may require further testing, medications or other treatments to help with improving dryness.

It is very important to remember that the behaviors that have created bladder instability often begin long before any symptoms are identified. Therefore, it will likely take time to reverse the habits and changes which have occurred. It takes dedication and commitment to ensure that treatment is followed closely.

Why choose Children's Colorado for your child's voiding dysfunction?

Our Bedwetting and Enuresis (BE) Program was created to specifically address children with wetting issues and dysfunctional voiding by using behavioral modifications and motivating techniques to help children attain success. Watches and alarms are given to the children in clinic to establish independence during this regimen.

• Patients keep voiding diaries to record their progress.
• Letters are written for schools to ensure compliance during classroom hours.
• Hints are also given to children to learn how to relax their pelvic floor during urination.
• Incentive programs are a useful method to promote compliance with the bowel and bladder program prescribed for children in the BE Program. Reward systems are discussed and established for patients and their parents. In addition, prizes are given in clinic if patients bring voiding diaries to follow-up appointments.

We work closely with the Gastroenterology Department to address any constipation issues that may be contributing to the dysfunctional voiding, as well with a clinical psychologist to help with the motivation and resistant behaviors that can accompany dysfunctional voiding. Our group is committed to helping you and your child attain success with the interventions and improve bladder function and eliminate leaking of urine, irritated voiding and/or recurrent UTIs, which are all symptoms of dysfunctional voiding.