Dysfunctional Voiding

Dysfunctional voiding, a term used to describe impairments of micturition, encompasses a wide array of symptoms and can lead to significant morbidity. The typical patient is a school-age girl who may be enuretic or have recurrent UTIs. Parents will often give a history that the child "holds her urine" or demonstrates urgency with infrequent voiding. Vincent's curtsy is a well-known posture assumed by these girls to help alleviate the pressure of a full bladder, which can result in a non-neurogenic neurogenic bladder. The dysfunctional voiding scoring system (DVSS) is a validated tool instrument that can be used to diagnose and evaluate children with dysfunctional voiding (Farhat et al., 2000). Urodynamic studies, cystoscopy, and imaging studies are available in the workup of voiding dysfunction, if indicated by the history and physical examination. Treatment is designed to improve bladder tone by placing the patient on a timed voiding schedule.

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