Voiding Dysfunction

About Voiding Dysfunction

Enuresis (involuntary peeing that is abnormal for a child’s age) is one of the most common types of voiding dysfunction, and includes both nighttime wetting (nocturnal enuresis) and daytime wetting (diurnal enuresis).

Children often exhibit posturing behaviors, (pee-pee dance, cross their legs, squat). Although it is normal for very young children to do this as they are learning to toilet train, sometimes these symptoms can continue even as the child grows older.

Voiding dysfunction may cause a child to run to the bathroom frequently. Children may have to urinate every 10-30 minutes or in less severe cases, every 1-3 hours. They will often urinate small volumes or feel the urge to urinate again soon after voiding.

 
What causes voiding dysfunction?

The bladder is a muscle that stores urine, and it empties by contracting the muscle. A normally functioning bladder only contracts when it is at full capacity (the normal amount of urine that it can hold comfortably) and it is time to void.

When the bladder is irritable or overactive, it tends to contract at will, regardless of how much urine it is holding. It’s important for you to know that what your child is feeling is real and they do not have conscious control over it.

Constipation often contributes to these symptoms of voiding dysfunction. Your child may have mild to moderate constipation without complaining and the rectum and colon can stretch to accommodate the stool. This causes pushing on the bladder resulting in urgency/frequency, a decrease in capacity, and incomplete emptying.

 
How is voiding dysfunction diagnosed and treated?
In diagnosing overactive bladder, your Nemours pediatric urology team will do few things to rule out infection, or any serious, but rare, disorder:
  • thorough health history
  • physical exam
  • urinalysis and urine culture
  • renal and bladder ultrasound to check for bladder and kidney abnormalities
  • urine flow study (which uses a special toilet to measure your child’s voiding pattern)
  • post void residual (similar to the ultrasound, this is done after voiding to make sure your child is able to empty his or her bladder completely)

We will also ask you to keep a Voiding/Bowel Diary (PDF). This diary provides invaluable information that helps our Nemours pediatric urologists assess your child’s exact voiding problem. It will tell us how frequently your child is voiding, how much their bladder is letting them hold, if there is wetting and when this wetting occurs in relation to voiding. It will also allow us to better assess their stooling pattern and assure there is no constipation.

Most children will outgrow the symptoms of overactive bladder on their own without intervention, if there is no abnormality present. Your Nemours urologist may recommend some medications to relax the bladder depending on your preference and the age of your child.

Addressing your child’s symptoms of overactive bladder and wetting can dramatically improve your child’s quality of life. We often see children’s nighttime bedwetting improve after their daytime symptoms are addressed.

A to Z: Cystitis

A to Z: Cystitis

Cystitis (sis-TYE-tis) is inflammation of the bladder, also known as a bladder infection. It's the most common type of urinary tract infection (UTI) and mostly affects children and adult women.

More to Know

Cystitis is usually caused by bacteria (typically E. coli) that enter the body through the urethra and spread to the bladder. If not treated, the infection can travel to the kidneys and become a more serious problem.

urinary tract

Cystitis can occur in people who are otherwise healthy and have no medical problems. Irritants such as bubble baths or feminine hygiene products, poor toilet or hygiene habits, an abnormality in the structure or function of the urinary tract, drug interactions, or long-term catheter use all can cause a bladder infection.

Symptoms of cystitis include a persistent urge to urinate (pee), a burning sensation when urinating, cloudy or strong-smelling urine, low-grade fever, and a feeling of pressure or pain in the lower abdomen.

Wetting accidents in toilet-trained children often indicate cystitis. For infants and young children, cystitis may be harder to detect because symptoms are less specific. Sometimes fever is the only sign.

Keep in Mind

Bladder infections are painful and inconvenient, but most are caused by bacteria and can easily be treated with antibiotics. If you have blood in your urine, pain with urination, back or side pain, fever, nausea or vomiting, or abdominal pain, see your doctor immediately as these are signs of a possible infection in the urinary tract.

All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts.

Reviewed by:
Date reviewed: September 26, 2016