Voiding Dysfunction Clinic
Children who are experiencing an interrupted or intermittent flow of urine might be suffering from voiding dysfunction. At the University of Chicago Medicine Comer Children's Hospital, or specialists offer comprehensive evaluation of voiding dysfunction, using state-of the art technology and the latest treatment options such as urodynamic testing and biofeedback therapy. With the help of our pediatric urologist and dedicated nurse specialist, we are committed to identifying any voiding dysfunction issues your child may have and working with your to best manage their condition.
Voiding dysfunction describes any irregularities your child may have in filling and/or emptying their bladder that does not include obstruction, neurologic, anatomic abnormalities in the urinary tract.
When a child voids urine normally, the bladder will contract and the sphincter relaxes to allow urine to flow. For a child with voiding dysfunction, the sphincter does not relax to allow urine to flow even though the bladder is contracting to signal that urination should occur.
If you suspect that your child may have issues emptying their bladder, there are some common signs and symptoms to watch out for, including:
- Daytime frequency/urgency: the bladder is full and contracting without the child intending to urinate.
- Tendency to hold urine for long periods of time
- Uncontrolled urine leakage
- Difficulty initiating flow of urine
- Straining (applying abdominal pressure) to initiate urination
- Weak or intermittent urine stream
If your child has one or more of these symptoms, please consult with your physician for further evaluation.
Diagnosing Voiding Dysfunction in Children
If you or your child's physician thinks that he or she may have voiding dysfunction, our experts will use advanced diagnostic technology to assess any potential condition, but first, we will complete a detailed evaluation and physical exam.
In order to properly identify your child's specific treatment needs, we might need to perform additional imaging, such as an ultrasound or an x-ray, or in some cases, further testing which could include:
- Voiding cystourethogram (VCUG) is a minimally invasive test that enables your physician to see your child's urinary tract and bladder to better analyze any issues.
- Urodynamics are tests that can measure how well the bladder and sphincter are performing. Should your child need any of these additional tests, our team will thoroughly explain what to expect and answer any questions you may have.
Related Bladder, Bowel and Pelvic Floor Conditions
Children with voiding dysfunction may also experience other chronic urinary and bowel problems. Our pediatric urology specialists at Comer Children's have the expertise to pinpoint each child's diagnosis and develop an effective care and treatment plan.
Bladder and bowel dysfunction (BBD) is a problem with regular bowel movements or urination. Since the bladder and bowel share the same nerves, children with constipation often also suffer from urinary issues. Chronic BBD can lead to no longer feeling the urge to use the bathroom and a higher risk for urinary tract infections.
Pelvic floor dysfunction is when muscles are weak, in spasm, or too tight.
This can lead to:
- Bowel and bladder leaking
- Daytime incontinence (no control over urinating or having a bowel movement)
- Dysfunctional elimination (not able to control or keep in stools or urine)
Treatment Options for Children with Voiding Dysfunction
Our experienced team will work with your child to overcome voiding dysfunction and enable him/her to retrain their body to urinate properly.
Biofeedback Therapy for Children with Pelvic Floor Dysfunction: What to Expect
Biofeedback therapy is ideal when your child has inadequate pelvic floor relaxation during urination, as it will teach him/her to voluntarily relax their muscles when urinating.
During an hour-long session, we will work with your child to practice relaxing their pelvic floor. By placing EMG electrodes on your child's abdomen and perineum, he or she can visualize their muscle activity and learn to control them by playing interactive computer games that require them to contract and relax their pelvic floor.
Typically, your child can learn proper muscle relaxation in six to eight sessions, with a standard schedule of once a week for the first three weeks and progressing to one session every other week after that.
What should we do at home?
In order to have the best results from the program, we will give your child exercises he/she should practice at home every day. As a parent, encouraging your son or daughter to complete all the components of their elimination plan, and keeping a symptom log will give them the best chance for success. At each session, our staff will check your symptom log, exercise progression and urination studies to evaluate your child's progress.
What to Eat and Drink, What Not to Eat and Drink
- Have your child drink plenty of water during the day.
- Do not have caffeine, carbonation (soda pop), citrus, chocolate, and food coloring.
- Fiber supplements and laxatives may be needed to reach these goals.
Going to the Bathroom, Double Voiding and Helping Your Child Empty Their Bladder
- Have your child go to the bathroom when they first wake up in the morning.
Practice timed-voiding every two hours during the day. Use the bathroom just before going to bed.
- Have your child practice double voiding. After your child has voided, have them count to 20 and try to void again.
- Make sure your child relaxes and does not rush when using the bathroom. This will help bladder emptying.
Managing Your Child's Constipation
- The goal is to have one or two soft and easy to pass bowel movements each day.
- Do not eat foods that can cause constipation such as milk, yogurt, cheese, ice cream, and white bread or rice.
- Have plenty of fiber-rich food in your child’s diet. These include whole wheat bread and cereals, vegetables, and fruit.