Dysfunctional voiding in children : dysfunctional voiding is a problem of the emptying phase of the bladder

Abstract

• Dysfunctional voiding is an abnormality of the voiding phase of bladder function. • Bowel and bladder function are intimately connected and both should be addressed in evaluation and management. • Uroflowmetry is the essential diagnostic test in dysfunctional voiding, and a staccato urine flow pattern is the mainstay of diagnosis. The emphasis is on non-invasive forms of evaluation and management. Formal urodynamic study is seldom needed. It is important to realise that there can be both high and low intra-vesical pressures in children with dysfunctional voiding. • Urotherapy, i.e. behavioural modification, is the basis of treatment, and medication is only ancillary. A team effort between medical caregivers, the family and the patient is fundamental in achieving long-term success.