Voiding Dysfunction

What is voiding dysfunction?

Voiding dysfunction means that your child is unable to completely empty her bladder.

  • In a normal cycle, your child’s bladder stretches easily when it fills with urine and then contracts fully during voiding.
  • There should be no premature contractions of the bladder or increases in pressure as it fills.
  • During the normal voiding phase, there should be complete relaxation of the external urethral sphincter muscle so the urine released from the bladder flows smoothly and completely, without interruption, as the bladder empties itself.
  • An interrupted or intermittent flow of urine or incomplete emptying are causes of voiding dysfunction.

What are the symptoms of voiding dysfunction?

Incontinence during the day and night may be the first sign that there is a problem.

Other symptoms include:

  • urinary tract infection
  • frequent urination
  • urgent urination
  • pain or straining with urination
  • hesitancy
  • dribbling
  • intermittent urine flow
  • pain in the back, flank, or abdomen
  • blood in the urine

What causes voiding dysfunction?

Sometimes, the disruption of the voiding cycle may be the result of a neurological problem. This could be the result of an abnormality of the spinal cord or brain that affects how nerves help control the function of the bladder and urinary sphincter.

However, it’s more often a learned problem. For example, your child may continually hold his urine in all day because he doesn’t want to stop playing to go to the bathroom.

Children get into this routine for different reasons:

  • Some may be routinely too busy to break for the bathroom.
  • Others may have experienced a urinary tract infection that caused pain and as a result are afraid of urinating.
  • Sometimes the problem is related to potty training.
  • A child may have taken on abnormal urinating habits from the beginning.

A hard cycle to break

Whatever the reason, some children get into a pattern of not relaxing their external urethral sphincters. Their bladders can tolerate this for months and in some cases years, depending on how hard the child works to avoid urinating.

Eventually the bladder muscle, which has to continually work against this voluntary blockage, will become so strong that it will overcome the blockage and periodically empty on its own, whether the child is sitting in a classroom or out on the soccer field.

How we address voiding dysfunction

Boston Children’s Hospital uses urodynamics testing to evaluate how your child’s bladder carries out its two main functions: filling and emptying. The results of this testing will allow your child’s physicians to better diagnose and voiding dysfunction.