If your bladder and other parts of the urinary system do not work together as they should, you may have a condition known as voiding dysfunction. This condition creates challenges with urination and can significantly affect your daily life.
Symptoms of voiding dysfunction include:
- Feeling as though your bladder never fully empties
- Having difficulty starting or maintaining the urine stream
- Urinating involuntarily
- Having a slow urination stream
- Urinating more than eight to 10 times a day
Causes and risk factors for voiding dysfunction
Voiding dysfunction usually occurs when muscles in the pelvic floor — which support internal organs like the bladder — are overactive or relaxed. Trouble with urinating may also be the result of nerve complications. Other causes may include:
- Benign or cancerous tumors in your bladder
- Bladder stones
- Blockages in your urethra
- Enlarged prostate
- Overactive bladder
- Prostatitis (a prostate gland disorder that causes inflammation, swelling and tenderness)
Diagnosing and treating voiding dysfunction
When diagnosing voiding dysfunction, your urologist will perform a physical exam and may ask you to track your urination patterns and symptoms for a short time. You may also need to undergo types of urodynamic testing, such as:
- Uroflowmetry, which measures the amount of urine you release and the speed of your urine flow
- Post-void residual (PVR) urine testing, which measures how much urine is left in your bladder after you urinate
Treatment for voiding dysfunction depends on the underlying cause of the problem and may involve both surgical and nonsurgical approaches. Your doctor or other health care provider may recommend:
- Nerve stimulation techniques. These therapies involve stimulating specific nerves to aid in bladder control and may include sacral nerve modulation or posterior tibial nerve stimulation.
- Injections. Intravesical Botox injections block faulty signals between your nerves and muscles that affect how often you feel the need to urinate.
- Sphincter and urethral support. These options are recommended for stress urinary incontinence and involve providing support to the urethra or the sphincter muscles (which control urine flow). They include the use of a prosthetic device known as an artificial urethral sphincter or a urethral sling, which is a band that puts pressure on your urethra to prevent urine leakage.
- Other nonsurgical approaches. Behavioral therapy and medications may also be used to treat voiding dysfunction.