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Dysfunctional Voiding

There are many signals that link between the bladder and the brain, and if these signals are out of sync it can cause many issues urinary incontinence issues for children. Children of the age of 4 and up who experience urinary incontinence and do not have a specific anatomical or neurological cause, providers may diagnose the child with voiding dysfunction.


This condition can impact children not only physically, but socially and psychologically as well. When voiding dysfunction is not treated, some cases can cause vesicoureteral reflux and long term kidney damage. With voiding dysfunction being more common in girls than boys, it is very important to be aware of the signs. There is also a strong connection between dysfunctional voiding and functional constipation.

Types of Dysfunctional Voiding & Their Symptoms

  • Overactive Bladder (OAB): OAB causes children to feel the need to urinate even when the bladder is not completely full. Use of the bathroom 10 or more times a day resulting in the use about every hour is a common symptom of Overactive Bladder. OAB is directly associated with Urinary Incontinence and Urinary Tract Infections, as they often go hand in hand. Another sign of Overactive Bladder is children attempting to "hold it" by sitting, crossing their legs, or other physical positions to avoid urinating. This type of voiding dysfunction is the most common, occurring in 22% of children from the ages of 5-7. 

  • Dysfunctional Voiding: This specific type of dysfunction occurs when the muscles in control of the urine flow out of the body do not fully relax, resulting in  bladder being unable to fully empty. Symptoms of Dysfunctional Voiding include both daytime and nighttime wetting, the sensation of the bladder always being full, urgency, and having to strain when urinating. In advanced cases, symptoms can progress and cause for higher risk or kidney infection and other diseases. 

  • Underactive Bladder: Symptoms of an Underactive Bladder are when children urinate less than 3 times a day or go more than 12 hours without urinating. This causes the child to have to strain to urinate because the bladder is too weak and is being unresponsive to the brain's signal that it is time to urinate. Another associated symptom with Underactive Bladder is accidental wetting from the bladder being too full and overflowing. 

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