Voiding Dysfunction - Urologist | UC Irvine Department of Urology

Doctor-discussing-voiding-dysfunction

Voiding dysfunction is a general term for a lack of coordination between the bladder and various parts of the urinary tract.

Voiding dysfunction can occur for many reasons, from an overactive bladder to tumors and scar tissue in the urethra. Since there are many possible sources of symptoms of this nature, patients are often referred to a urologist for further evaluation. Patients with a voiding dysfunction may:

Urinate frequently
Have difficulty going
Experience an involuntary loss of urine

What Causes Voiding Dysfunction?

Issues with voiding are typically caused by relaxed or overactive pelvic floor muscles. In some instances, a voiding dysfunction may be caused by nerve-related malfunctions or abnormalities. Nerve problems could also trigger irregular bladder contractions. Other possible causes include blockages within the urethra, bladder stones, and cancerous or benign tumors in the bladder.

Overactive bladder muscles can sometimes contribute to the problem as well, especially if contractions of bladder muscles override the actions of sphincter muscles of the urethra. In men, the problem may be caused by an enlarged prostate or a similar issue due to prostatitis, referring to a prostate that’s swollen, inflamed, or tender.

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Common Symptoms or Signs

Frequent urination is a common early sign of voiding dysfunction. “Frequent” is usually defined as having to void more than 8-10 times a day. Some patients may experience urge incontinence, or an involuntary loss of urine that occurs when there’s a sudden urge to urinate. Related lower urinary tract symptoms (LUTS) may include:

Intermittent urine streams
A feeling that urination isn’t complete
Slow urination flow

How Is Voiding Dysfunction Diagnosed?

After a physical exam, a urologist performs certain tests to pinpoint the reason for voiding dysfunction. This type of evaluation may include uroflowmetry to measure how much urine is produced during voiding and the speed of urine flow. Patients are sometimes asked to keep a voiding chart for a short period of time to assess urination patterns. A post-void residual (PVR) urine test is sometimes done to measure the amount of urine that’s still in the bladder following urination.

Treatment Options

If symptoms aren’t related to a problem with the bladder requiring separate treatment, such as a tumor, treatment for voiding dysfunction may involve pelvic floor therapy to recondition or strengthen muscles within the pelvis. Such exercises typically focus on muscles around the uterus or prostate and large intestines. Pelvic floor muscle training may also involve pretending to go and then holding it.

If intermittent self-catheterization (ISC) is recommended as a treatment, patients will be taught how to insert a urinary catheter during times when there’s an urge to urinate. After urination is completed, the catheter is removed. Medications prescribed may include muscle relaxants. If voiding dysfunction is related to nerve issues, a neuromodulation device may be surgically implanted to deliver electrical impulses to manage nerve signals.

For some individuals, the risk of experiencing a voiding dysfunction may be reduced by performing exercises to strengthen pelvic floor muscles proactively before a possible problem with urination develops. Getting into the habit of drinking plenty of water, keeping weight within a normal range, and avoiding overly acidic foods can also play a role in maintaining normal urinary system functions.