About voiding dysfunction

Going to the bathroom isn’t always as simple as it sounds. In fact, urinating requires a series of coordinated signals and responses between the brain and the lower urinary tract (the bladder and urethra). Children whose bodies can’t coordinate these signals may have trouble holding their urine. Simply put, they may not always realize when their bladder is full, which can lead to urinary incontinence. Or, their pelvic muscles may be overactive, which sends them to the bathroom multiple times a day – even when they do not need to urinate.

Voiding dysfunction is a broad term that describes several conditions that affect the coordination between the muscles in the lower urinary tract. It is typically diagnosed in children over the age of four who do have a clear anatomical or neurological diagnosis for frequent urination or urinary incontinence. The most common voiding dysfunctions include:

Dysfunctional voiding occurs when the muscles that control the flow of urine never fully relax, which does not allow the bladder to empty entirely.
Overactive bladder causes children to feel an urgent need to urinate, even when the bladder is not full.
Underactive bladder occurs when the bladder muscle is weak and misses the brain’s signal to empty a full bladder.

Our team of urologists understands how frustrating, and, at times, embarrassing voiding dysfunction can be for children. We work closely with the children and families we see, along with specialists in nephrology, neurology, psychology and many other disciplines, to create a plan that builds your child’s confidence.

Is voiding dysfunction common in children?

Voiding dysfunction is more common than you may realize. According to the American Academy of Pediatrics, as many as 20% of school children have experienced at least one symptom of voiding dysfunction. Overactive bladder is the most common type of voiding dysfunction. It occurs in 22% of children, ages 5 to 7 years old.

Causes of voiding dysfunction

There is no clear cause of voiding dysfunction. However, it is very important to diagnose and treat these conditions, as they can lead to long-term kidney damage if left untreated. Voiding dysfunction can also impact a child’s social and emotional well-being.

Signs of voiding dysfunction

Symptoms of voiding dysfunction can vary based on the specific condition your child has. Learn more about the most common symptoms for dysfunctional voiding, overactive bladder and underactive bladder.

Symptoms of dysfunctional voiding

Daytime wetting
Bedwetting
Feeling like the bladder is always full
Urinary urgency
Straining to urinate

Symptoms of overactive bladder

Uses bathroom more than ten times each day
Urinary incontinence
Frequent urinary tract infections

Symptoms of underactive bladder

Urinates less than three times each day
Straining to urinate
Urine leaking (accidental wetting)

What can you do about voiding dysfunction?

There are many treatments and therapies that may help your child regain control of their bladder function. Your child’s care team will discuss each treatment option with you based on their diagnosis and goals for treatment. Those options may include:

Managing constipation: A high-fiber diet, drinking plenty of water and taking a prescribed laxative can help improve constipation (which sometimes accompanies voiding dysfunction) and improve your child’s urinary symptoms, too.
Pelvic floor therapy: Certain exercises can help strengthen the pelvic floor muscle, which can give your child more control over their lower urinary tract.
Medication: Sometimes, prescription medicine can help calm overactive muscles.
Behavioral training: Encourage your child to drink plenty of fluids and remind them to urinate every 2 to 3 hours during the day. Your doctor will discuss a “voiding schedule” that’s best for your child.