What is voiding dysfunction?
Voiding dysfunction is a broad term use to describe a voiding
(urination) pattern that is abnormal for the child's age. A normal
bladder stretches easily as it fills with urine. It does not
contract or increase in pressure as it fills. As the bladder
contracts during normal voiding, the external urethral sphincter
muscle should completely relax so that the urine released from the
bladder flows smoothly, completely, and without interruption. A
problem in bladder filling or emptying is called a voiding
dysfunction.
What causes voiding dysfunction in children?
Voiding dysfunction can be the result of numerous causes:
- Behavioral problems or poor habits (eg, infrequent
voiding, poor toileting habits, having too much fun or being too
busy to break to go to the bathroom, being fearful of urinating due
to a past painful urinary tract infection, attention deficit
disorder, psychological or emotional stressors)
- Congenital (born with) problems in the physical anatomy
of the urinary tract
- Acquired problems in the physical anatomy of the urinary
tract (such as those caused by tumors or trauma)
- Central nervous system diseases and conditions that
affect the urinary tract (eg, cerebral palsy, epilepsy, multiple
sclerosis, other abnormalities of the brain or spinal cord that
affects the nerves that control bladder or urinary sphincter
function)
- Endocrine or kidney diseases that affect the urinary
tract (eg, diabetes, chronic kidney disease)
- Genetic diseases that affect the urinary tract (eg,
Ochoa syndrome, Williams syndrome)
- Infections or irritations that affect the urinary tract
(eg, urinary tract infections, urethritis, pinworms, foreign body)
- Other causes can include stress incontinence (the
involuntary loss of urine during activities such a coughing, or
sneezing), giggle incontinence (see next page for definition), and
delayed nighttime bladder control.
What are the symptoms of voiding dysfunction?
Signs and symptoms of voiding dysfunction include:
- Incontinence (urine leakage) during the day and/or night -
often is the first sign noticed by parents that there is a problem
- Increase in urinary frequency and/or urgency (the need to void immediately)
- Urinary hesitancy, dribbling, intermittent urine flow and/or straining at urination
- Pain in the back, flank or abdomen
- Recurrent urinary tract infections
- Blood in the urine
- Infrequent urination - three or fewer voids in a 24-hour period
- Constipation and fecal soiling
Are there different types of voiding dysfunction?
Yes. Some of the more common types include:
Daytime wetting (also called diurnal enuresis): Daytime
wetting can consist of either small urine leaks that spot or dampen
underwear to the complete soaking of undergarments. Wetting occurs
more commonly in the afternoon, as most children are anxious about
wetting in school and work hard to stay dry.