Pediatric Voiding Dysfunction: Definitions and Management
Abstract
1. Introduction—Pediatric Voiding Dysfunction
2. Pediatric Bladder Dysfunction Definitions
3. Associated Conditions with Pediatric Voiding Dysfunction
4. Workup for Pediatric Lower Urinary Tract Dysfunction
5. Treatment for Pediatric Voiding Dysfunction
6. Importance of Recognizing and Treating Pediatric Voiding Dysfunction
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
COVID | Coronavirus Disease |
VD | Voiding Dysfunction |
LUTD | Lower Urinary Tract Dysfunction |
BBD | Bowel Bladder Dysfunction |
LUTS | Lower Urinary Tract Symptom |
UTI | Urinary Tract Infection |
ICCS | International Children’s Continence Society |
ADHD | Attention-Deficit/Hyperactivity Disorder |
ASD | Autism Spectrum Disorder |
DM | Diabetes Mellitus |
DVSS | Dysfunctional Voiding Symptom Score |
BMI | Body Mass Index |
MRI | Magnetic Resonance Imaging |
EMG | Electromyography |
VCUG | Voiding Cystourethrogram |
CIC | Clean Intermittent Catheterization |
OAB | Overactive Bladder |
PTNS | Posterior Tibial Nerve Stimulation |
FDA | Food and Drug Administration |
VUR | Vesicoureteral Reflux |
QOL | Quality of Life |
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Storage Symptoms | |
Increased voiding frequency | Daytime urinary frequency of 8 or more voiding episodes a day |
Decreased voiding frequency | Daytime urinary frequency of 3 or fewer voiding episodes a day |
Incontinence | “Involuntary leakage of urine” |
Urgency | “Sudden and unexpected experience of an immediate and compelling need to void” in patients who have already achieved control of their bladder |
Nocturia | Awakening overnight to void, but not resulting in incontinence. If child is incontinent overnight or wakes up after being incontinent, this does not fall under the term of “nocturia”. |
Voiding Symptoms | |
Hesitancy | “Difficulty in initiating voiding when the child is ready to void” |
Straining | “Intense effort to increase intra-abdominal pressure in order to initiate and maintain voiding” |
Weak Stream | Weak observed or uroflow stream |
Intermittency | Several stop and start episodes during voiding |
Dysuria | Burning, pain, or discomfort experienced during voiding |
Other Symptoms | |
Holding maneuvers | Behaviors such as “standing on tiptoes, forcefully crossing legs, grabbing or pushing on the genitals or abdomen and placing pressure on the perineum” with a goal of delaying urination |
Feeling of incomplete emptying | Sensation that bladder was not emptied after voiding |
Urinary retention | Failure to void despite a distended and full bladder |
Post-micturition dribble | Involuntary urinary leakage after completion of voiding |
Spraying or spitting of the urinary stream | Urine does not flow in one stream but is rather “sprayed” or “split” in direction |
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Lusnia, C.; DeMarco, R.; Sharadin, C. Pediatric Voiding Dysfunction: Definitions and Management. Medicina 2025, 61, 594. https://doi.org/10.3390/medicina61040594
Lusnia C, DeMarco R, Sharadin C. Pediatric Voiding Dysfunction: Definitions and Management. Medicina. 2025; 61(4):594. https://doi.org/10.3390/medicina61040594
Chicago/Turabian StyleLusnia, Ciara, Romano DeMarco, and Cynthia Sharadin. 2025. "Pediatric Voiding Dysfunction: Definitions and Management" Medicina 61, no. 4: 594. https://doi.org/10.3390/medicina61040594
APA StyleLusnia, C., DeMarco, R., & Sharadin, C. (2025). Pediatric Voiding Dysfunction: Definitions and Management. Medicina, 61(4), 594. https://doi.org/10.3390/medicina61040594