Urogynaecology

Voiding dysfunction

Women with often can have issues with bladder emptying.

This may include:

• Bladder sensation abnormalities: feeling of incomplete emptying or reduced urge to void

• Urine stream abnormalities: slow or intermittent stream.

• Voiding abnormalities: hesitancy in initiating flow of urine, straining to void, and needing to splint (reduce a vaginal bulge) to start flow of urine.

• Urinary incontinence or leakage from the over filled bladder.

There are two main reasons for difficult bladder emptying. It could be due to underactive(weak) bladder muscle or obstruction of the urethra. Often this is diagnosed by combination of tests- urodynamics(bladder tests) and cystoscopy.

The two major complications of bladder emptying issues is risk of recurrent urinary tract infections and back pressure effects on the kidneys. A kidney scan may be suggested in view of this risk.

Treatment includes double or triple voiding techniques that may help in emptying the urine left in the bladder. This involves passing urine more than once each time you go to the toilet. Treatment will depend on the underlying cause, complications and volume left behind in the bladder. Sometimes the only solution is to use a catheter to empty the urine in bladder (Clean intermittent self catheterisation) especially if the bladder muscle is very weak. If this is the only solution, we will teach you to use a catheter yourself as well as arrange the supplies for your use.