Voiding dysfunction is not a single condition, but an umbrella term to describe different issues that are associated with improper coordination between the urethra and the bladder muscle. The result is either over-activity or improper relaxation of the pelvic floor muscles when a patient is urinating.
When someone is experiencing voiding dysfunction, there are various symptoms that might occur. In most cases, these symptoms include urinary urgency, urinary frequency, urinary retention, or a combination of these.
When the bladder is overactive, symptoms may include:
Suddenly feeling the urge to urinate and having difficulty controlling it
Urinating eight or more times per day
Having to urinate at least twice at night
When the patient is experiencing urinary retention, the following symptoms might occur:
Complete inability to urinate
Inability to fully empty the bladder when urinating
Dribbling after urination
Slowed urine flow
Frequently feeling the urge to urinate
Treatment of Voiding Dysfunction
Treatment ultimately depends on the exact issue a patient is experiencing and how severe the symptoms are. The first step is to get an accurate diagnosis. Doctors generally begin with a physical examination to assess the patient’s health and to learn more about the urinary symptoms that they are experiencing. Blood work, urine testing and imaging tests might be recommended to determine the underlying cause of the patient’s voiding dysfunction.
Patients who are completely unable to urinate should get urgent treatment. At the hospital, the patient may have a catheter inserted to drain the urine being retained in the bladder. If this becomes a chronic problem for the patient, there are catheter options that they can utilize long-term. These include clear intermittent catheterization, a suprapubic catheter or an indwelling catheter. The best choice ultimately depends on the severity of the patient’s urinary retention and their overall health.
For bladder over-activity, intermittent catheterization may also be recommended. Patients might benefit from using Kegel exercises to strengthen their pelvic floor muscles. Scheduling trips to the bathroom to urinate could aid patients in preventing accidents by not allowing the bladder to fill completely before emptying it. Other possible treatments may include using absorbent pads to catch urine leakage and bladder training.
Certain medications might help to control the patient’s symptoms associated with an overactive bladder. There are oral and topical options. Nerve stimulation and bladder injections may be considered if more conservative treatments are ineffective. There are also surgical options to aid in improving the capacity of the bladder, but these are generally reserved for severe symptoms.
Voiding dysfunction is not uncommon. Patients may have abnormalities with the storage, filling and emptying of urine. In some cases, they experience more than one of these issues.