Voiding Dysfunction

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Voiding dysfunction is a broad term, and refers to any abnormality regarding the emptying, filling, or storage of urine.

Good bladder control requires complex coordination between the nerves and muscles involved, and any failure along the way can lead to a set of uncomfortable symptoms known as voiding dysfunction.

For example, the pelvic floor muscles become overactive and may not completely relax after urination as they should. This leads to symptoms that can be both disruptive and embarrassing.

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Symptoms

One of the major symptoms of voiding dysfunction is frequent urination. Urination more than eight times per day is considered frequent. Sudden, intense urges to urinate may occur. There may also be a lingering urge to urinate, even immediately after urination, due to incomplete voiding of the bladder. Patients may experience bladder leaks, especially when pressure is applied to the bladder. Involuntary urination is possible. The symptoms of voiding dysfunction are wide-ranging, and may be experienced individually or in any combination.

Causes of Voiding Dysfunction

Voiding dysfunction can have causes that are not due to underlying disease or impairment. Excessive amounts of vitamins or food additives such as caffeine, artificial sweeteners, or vitamin C can create symptoms. In addition, certain medications—especially muscle relaxers and sedatives—may produce reduced bladder control as a side effect. Other potential causes that are not necessarily related to disease include constipation, hormonal changes due to age or pregnancy, damage during hysterectomy surgery, and prolapse caused by childbirth.

Certain diseases and medical conditions may cause the symptoms of voiding dysfunction. A urinary tract infection can irritate the bladder, resulting in urgent or frequent urges to urinate. In older men, a benign enlargement of the prostate can occur and create symptoms. A tumor within the urinary tract can also create problems. Less commonly, voiding dysfunction may result from prostate cancer, a brain tumor, stroke, or a spinal injury. Because voiding dysfunction is a symptom rather than an illness, the cause of the dysfunction is worth investigating. Treatment of the cause may eliminate or reduce the symptom.

Treatment Options

Changes in daily activity may be recommended as a treatment or partial treatment of voiding dysfunction. Changes to diet and controlled fluid intake may help control symptoms. Scheduling regular trips to the bathroom can help to prevent sudden, intense urges. The “double voiding” technique may also be employed, and involves urinating twice in a row to attempt to fully empty the bladder. Regular pelvic floor exercises may improve bladder control. Medications to control symptoms are also available.

More invasive procedures may be necessary when behavioral changes and exercises are insufficient. Injections of bulking materials designed to help keep the urethra closed may provide some relief. Botox injections are sometimes used to reduce feelings of urgency. Surgery may also be recommended depending on the cause of the voiding dysfunction.