Voiding Dysfunction in Children

What is voiding dysfunction?

Voiding dysfunction is a term that means your child’s bladder is not emptying — he or she is not urinating — normally or fully.

urinary system

What causes voiding dysfunction in children?

Voiding dysfunction can be caused by:

Other causes can include stress incontinence (the involuntary loss of urine during actions such as coughing or sneezing), giggle incontinence (see next page for definition), and delayed nighttime bladder control.

What are the symptoms of voiding dysfunction?

Signs and symptoms of voiding dysfunction include:

Are there different types of voiding dysfunction?

Yes. Some of the more common types include:

What is the difference between voiding dysfunction and overactive bladder?

Overactive bladder is a condition in which the large bladder muscle (detrusor) contracts involuntarily, causing symptoms including urinary frequency, urgency and or/or urge incontinence. Urinary incontinence is the involuntary leakage of urine. Urinary incontinence can range from the occasional leakage of urine to a complete inability to hold any urine and can be one symptom of overactive bladder.

How is voiding dysfunction diagnosed?

If your child is experiencing a voiding problem, he or she will be referred to pediatric urology. Other members of the team might include behavioral psychologists, pediatricians, family practice physicians, and nurse practitioners.

Medical and social histories. The provider will take a history of your child's urination patterns and may ask you to create a voiding diary (to track frequency and volume). In addition, the doctor will ask about your child's bowel function (frequency, volume, caliber, staining, abdominal pain).

Physical and neurology exam. The provider will then conduct a thorough physical exam, including examination of the back, rectum and genitalia (for anatomic abnormalities). The neurologic exam will include careful attention to the lower extremities, including tone, strength, sensation, and reflexes.

Lab tests. A urinalysis, urine culture, and blood test (i.e., serum creatinine level) are conducted to gain an initial view of kidney function.

Other specialized tests. Certain radiologic and urodynamic tests (a test that provides details of bladder storage and emptying functions) may be ordered to help confirm the diagnosis and to document treatment effects. Other tests that may be ordered include:

How is voiding dysfunction treated?

Treatment options are based on the underlying cause of the voiding dysfunction, severity of symptoms, and findings from the physical, laboratory, and medical test results. Treatment may consist of one or more of the following approaches. Your providers will discuss which specific method(s) will be tried with your child.



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