The urinary tract is composed of a series of organs that are designed to collect and store urine as well as release it from the body. These organs include the kidneys, ureters, bladder, and urethra.
Unfortunately, there are abnormalities that may occur in the urinary tract that affect the body’s ability to fill, store, and release urine. This broad condition is known as Voiding Dysfunction and can adversely affect one’s quality of life.
Dr. R. Robert Dhir, at HTX Urology, is a urinary specialist helping patients in the greater Houston Texas area with controlling bothersome symptoms associated with voiding dysfunction. He will determine the underlying cause of voiding dysfunction in order to present curative options to eliminate urinary troubles.
What is Voiding Dysfunction?
Voiding dysfunction is a term that is used to describe an abnormal urination pattern. It can affect men, women, and children. For some, it can cause frequent and uncontrollable urination with incontinence. For others, it can hinder their ability to empty the bladder completely – a condition called urinary retention.
Voiding dysfunction may be caused by congenital abnormalities, trauma, history of pelvic surgery, presence of urinary tumor, poor toileting habits, complex urinary tract infections, or emotional or psychological stress. It may also be associated with other neurological, endocrine, or genetic disorders.
Voiding dysfunction can be categorized as:
- Non-Neurogenic Voiding Dysfunction: This is the most common type. It occurs in men, women, and children and can present with many different urinary symptoms such as difficulty emptying the bladder, trouble controlling the bladder, or bedwetting (seen mostly in children).
- Neurogenic Voiding Dysfunction: This is also known as neurogenic bladder. Neurogenic voiding dysfunction results in urinary problems due to problems of the nervous system – problems involving the brain, spinal cord, or nerves.
What are the Symptoms of Voiding Dysfunction?
Patients suffering from voiding dysfunction may experience some of the following symptoms:
- Urinary incontinence
- Straining to empty the bladder
- Recurring urinary tract infections
- Crossing legs or squatting to hold urine (seen in children)
- Frequent or urgent signals to urinate
- Urinating multiple times at night
- An inability to completely empty the bladder
- Waiting long periods of time to get the urine stream started
How can Voiding Dysfunction be Diagnosed?
Dr. Dhir will personally perform a thorough medical history and physical exam. This may include a pelvic exam for women, or a genital and prostate exam for men. He may recommend a bladder diary to track urinary symptoms, fluid intake, and leakage episodes.
He may recommend the following diagnostic tools prior to treatment:
- Urinalysis: Used to identify microscopic blood or presence of infection.
- Blood Tests: A PSA blood test is used to rule out prostate cancer in males.
- Urinary Tests: Urine cultures isolate bacteria in the urine; urine cytology is used to rule out tumor cells in the urinary tract.
- Cystoscopy: A small camera is placed into the bladder in the office setting.
- Urodynamics: In-office testing that checks how the bladder fills, holds, and eliminates urine as well as measures bladder muscle pressures.
- Imaging: Ultrasound, CT scan, MRI, or Nuclear Renal Scan are some of the modalities used to look for kidney stones, urinary obstructions, masses, or problems with kidney function.
What are the Treatments of Voiding Dysfunction?
The treatment of voiding dysfunction varies based on the underlying diagnosis. Below are examples of possible treatments:
- Bladder Training: Timed voiding every 2 hours or using abdominal muscles to help fully empty the bladder may be recommended. Bladder Training can also help hold urine longer to minimize frequent trips to the restroom.
- Pelvic Floor Physical Therapy: A pelvic floor physical therapist can help patients strengthen weak pelvic floor muscles or help teach muscle relaxation techniques to assist in proper urination.
- Diet Changes: Elimination of bladder triggering foods, minimizing alcohol, and smoking cessation can help with voiding dysfunction.
- Antibiotics: Chronic, undiagnosed urinary infections can often worsen symptoms. Antibiotics will be prescribed to treat an infection if diagnosed.
- Medications: Certain medications can be used to calm or relax the bladder if it is overactive. Additionally, medications can be used to help pass blocking kidney stones or relax and shrink a blocked prostate.
- Bladder Botox: Bladder Botox can be injected into the bladder muscle several times a year to prevent frequent or urgent urination when oral medications fail.
- Nerve Stimulation: Stimulating the tibial nerve through the skin (percutaneous tibial nerve stimulation, or PTNS) is an alternative to medication for overactive bladder. Sacral nerve stimulation (SNS) is another option to calm the pelvic nerves that lead to bladder dysfunction.
- Surgery: If lesions of the urinary tract are contributing to voiding dysfunction, surgery may be needed to biopsy and remove them. A urinary blockage may need surgery as well, such as removal of a kidney stone or removing tissue from a blocked prostate.
- Self-Catheterization: Also known as clean intermittent catheterization (CIC), underactive bladders that cannot fully empty may require the patient to insert a catheter to drain the bladder several times a day. This technique will be taught by Dr. Dhir in the office setting.
Contact Our Office
If you are interested in learning more about the treatment options for voiding dysfunction in Webster, Houston, and the surrounding areas of Texas, please contact our office at 281-946-6462 to schedule your informative consultation with Dr. R. Robert Dhir.
You can also schedule your appointment online by clicking here.
Dr. Dhir is a highly skilled, board-certified urologic surgeon with over 10 years of urological experience. He will happily guide you through the diagnostic and treatment process and help develop a personalized plan for your urologic needs.