{"id":137,"date":"2021-06-16T04:37:31","date_gmt":"2021-06-16T04:37:31","guid":{"rendered":"http:\/\/www.paedsurgeryindelhi.com\/blog\/?p=137"},"modified":"2021-06-16T04:40:02","modified_gmt":"2021-06-16T04:40:02","slug":"voiding-dysfunction","status":"publish","type":"post","link":"https:\/\/www.paedsurgeryindelhi.com\/blog\/voiding-dysfunction\/","title":{"rendered":"Voiding Dysfunction"},"content":{"rendered":"\n<p>Voiding dysfunction means that the child is  unable to completely empty his or her bladder and has an abnormal voiding  pattern i.e. interrupted or intermittent flow of urine.<\/p>\n   <h4> <strong>Normal voiding pattern involves -:<\/strong><\/h4>\n<ul class=\"list01\">\n  <li>During the filling phase &#8211; The child\u2019s bladder       should stretch easily when it fills with urine and then contracts fully       during voiding. There should be no premature contractions of the bladder       or increase in pressure as it fills.<\/li>\n  <li>During the normal voiding phase-: there should       be complete relaxation of the external urethral sphincter muscle, so the       urine released from the bladder flows smoothly and completely, without       interruption, as the bladder contracts and empties itself without       excessive increase in pressures.<\/li>\n<\/ul>\n<h4><strong>What causes voiding dysfunction?&nbsp;<\/strong> <\/h4>\n<p>  Sometimes, the disruption of the voiding  cycle may be the result of a neurological problem. This could be the result of  an abnormality of the spinal cord or brain that affects how nerves help control  the function of the bladder and urinary sphincter ie Neurogenic bladder.<\/p>\n  <p>However, it\u2019s more often a problem of toilet  training ie Non neurogenic. For example, the child may continually hold his  urine in all day because he doesn\u2019t want to stop playing to go to the bathroom.<\/p>\n <p> Children get into this routine for different  reasons:<\/p>\n<ul class=\"list01\">\n  <li>Some may be routinely too busy to break       for the bathroom.<\/li>\n  <li>Others may have experienced a urinary       tract infection that caused pain and as a result are afraid of urinating.<\/li>\n  <li>Sometimes the problem is related to       potty training.<\/li>\n  <li>A child may have taken on abnormal       urinating habits from the beginning.<\/li>\n<\/ul>\n<p>Whatever the reason, some children get into a  pattern of not relaxing their external urethral sphincters. Their bladders can  tolerate this for months and in some cases years, depending on how hard the  child works to avoid urinating.<\/p>\n <p> Eventually the bladder muscle, which has to  continually work against this voluntary blockage, will become so strong and  thick that it will overcome the blockage and periodically empty on its own,  whether the child is sitting in a classroom or out on the soccer field.<\/p>\n<h4><strong>What are the symptoms of voiding  dysfunction?&nbsp;<\/strong> <\/h4>\n  <p>Incontinence during the day and night may be  the first sign that there is a problem.<\/p>\n  <p>Other symptoms include:&nbsp; <\/p>\n<ul class=\"list01\">\n  <li>urinary tract infection <\/li>\n  <li>frequent urination<\/li>\n  <li>urgent urination<\/li>\n  <li>pain or straining with urination<\/li>\n  <li>hesitancy<\/li>\n  <li>dribbling<\/li>\n  <li>intermittent urine flow<\/li>\n  <li>pain in the back, flank or abdomen<\/li>\n  <li>blood in the urine<\/li>\n<\/ul>\n<h4><strong>How  is voiding dysfunction diagnosed?&nbsp;<\/strong> <\/h4>\n<p>A detailed history of the child&#8217;s voiding  patterns and a voiding diary made by the parents, help in making a diagnosis.<\/p>\n<p> This is followed by a thorough physical  examination, urinalysis and urine culture. Radiologic and urodynamic evaluation  (a detailed study of bladder function) may be used to both confirm the  diagnosis of a dysfunctional voiding pattern and to document its aftereffects.<\/p>\n <p> Further evaluation of the urinary tract is  dictated by the severity and character of the child\u2019s symptoms. Some additional  test may be required like -:<\/p>\n<ul class=\"list01\">\n  <li><strong>VoidingCystoUrethroGram (VCUG)<\/strong><strong>&nbsp;<\/strong>\u2014       A special x-ray that examines the child\u2019s urinary tract. The images will       show if there is any reverse flow of urine into the ureters and kidneys ie       Vesicoureteral Reflux or any to obstruction to the flow of urine.<\/li>\n  <li><strong>Ultrasound KUB<\/strong><strong>&nbsp;<\/strong>\u2014       The test is used to determine the size and shape of well your child\u2019s       kidney, and to detect a mass, kidney stone, cyst, or other obstruction or       abnormalities.<\/li>\n  <li><strong>Blood tests<\/strong>&nbsp;\u2014       To see how well the child\u2019s kidneys are working.<\/li>\n<\/ul>\n<h4><strong>How  is voiding dysfunction treated?<\/strong> <\/h4>\n<p>Most treatment begins with a timed voiding  schedule where the child is asked to go to the bathroom right when he wakes up,  every two to three hours thereafter, and upon going to bed at night.<\/p>\n <p> It\u2019s also important to make child completely  relax while urinating. These simple changes are often enough to help the child  work through the problem.<br>\n  In some children, however, medication may be  necessary to decrease bladder hyperactivity.<\/p>\n<p>  Rarely, extensive reconstructive surgery such  as&nbsp;bladder augmentation (adding a  piece of the intestine or stomach to the bladder to increase bladder capacity)  may be necessary.<\/p>\n <p> It\u2019s essential to prevent urinary tract  infections and make sure that any other associated problems, such as  vesicoureteral reflux, bladder dysfunction, or kidney problems, etc are being  appropriately controlled.<\/p> \n <p> The key with voiding dysfunction is to  identify it early on, treat it, and limit the possible negative effects it can  have on the child\u2019s urinary system.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Voiding dysfunction means that the child is unable to completely empty his or her bladder and has an abnormal voiding pattern i.e. interrupted or intermittent flow of urine.<\/p>\n","protected":false},"author":1,"featured_media":138,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[54],"tags":[55],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.10 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Voiding Dysfunction<\/title>\n<meta name=\"description\" content=\"Voiding dysfunction means that the child is unable to completely empty his or her bladder and has an abnormal voiding pattern i.e. interrupted or intermittent flow of urine.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.paedsurgeryindelhi.com\/blog\/voiding-dysfunction\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Voiding Dysfunction\" \/>\n<meta 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