Female Voiding Dysfunction

It is estimated that as many as 25 million Americans suffer from bladder control problems. Voiding dysfunction is a condition in which the bladder does not function properly.

The lower urinary tract, which includes the bladder and urethra, allows for storage and timely release of urine. Voiding dysfunction is a broad term, used to describe conditions where there is poor coordination between the bladder muscle and the urethra. This results in incomplete relaxation or overactivity of the pelvic floor muscles during voiding.

A variety of specific definitions exist; the International Continence Society and International Urogynecological Association define female voiding dysfunction as “abnormally slow and/or incomplete micturition (voiding) based on symptoms and urodynamic investigations.”

Voiding dysfunction can manifest as a wide range of symptoms which can include difficulty in emptying bladder, urinary hesitancy, slow or weak urine stream, urinary urgency, urinary frequency or dribbling of urine.

Voiding dysfunction can be due to nerve dysfunction, non-relaxing pelvic floor muscles or both. Voiding dysfunction is also classified as being caused by either underactivity of the bladder (detrusor) or outflow (urethra).

Evaluation by a clinician may include tests, such as uroflowmetry, post-void residual and pressure flow studies.

Treatment is individualized, depending on specific conditions that exist in each patient.

Possible treatments include pelvic floor therapy, intermittent self-catheterization, muscle relaxants or placement of a neuromodulation device.