It is estimated that as many as 25 million Americans suffer from bladder control problems. Voiding dysfunction is a general term to describe the condition where there is a lack of coordination between the bladder muscle (detrusor) and the urethra. With normal urination, the urethra relaxes and opens when the bladder muscle contracts allowing urine to freely pass out of the body. In those with voiding dysfunction, the urethra does not relax when the bladder muscle contracts, making it difficult for urine to pass.
There are several different types of voiding dysfunction:
Urinary incontinence is any involuntary leakage of urine, whether it’s a large amount or just a few drops. The four most common types of urinary incontinence are: stress urinary incontinence, urge incontinence, mixed urinary incontinence, and overflow incontinence. The condition can occur in these same four forms:
Stress Incontinence. Urine leakage is caused by an increase in abdominal pressure, such as sneezing, coughing, or laughing.
Urge Incontinence. An urge to urinate occurs suddenly. Patients may be unable to make it to the toilet before leakage occurs.
Mixed Urinary Incontinence. Urinary problems may be a combination of stress and urge incontinence.
Overflow Incontinence. The bladder is unable to empty properly causing the patient to leak and urinate frequently.
This condition is characterized by urinary frequency, urgency, or urge incontinence. It can occur in both men and women, but women are affected with the condition more often. Typically, overactive bladder occurs later in life.
Nonobstructive Urinary Retention
This condition is characterized by the inability to completely empty the bladder. Patients typically produce a weak or dribbling stream of urine.
Specific condtions such as benign prostatic hyperplasia (BPH), cancer, or urethral structures may interfere with the body’s ability to completely pass urine.
Tests that may be performed to diagnose voiding dysfunction include: urinalysis, cystoscopy (looking into the bladder), urodynamics (the study of bladder function and urine flow), or bladder scan (a noninvasive procedure that measures the amount of urine left in the bladder).
Many nonsurgical and behavioral techniques can be used to help treat voiding dysfunction. Medication, Kegel exercises, biofeedback, timed voiding, and bladder training are a few options used by urologists.
Several minimally invasive procedures, as well as more extensive surgical procedures may be necessary to treat voiding dysfunction. Commonly performed procedures include collagen injections, pubovaginal slings, microwave treatments for enlarged prostates (BPH), bladder augmentation, or insertion of artificial urinary sphincters.