Voiding Dysfunction
Voiding dysfunction in men is often due to an obstruction.
Problems with urination related to poor coordination between bladder muscles and the tube that carries urine out of the body (urethra) are broadly described as voiding dysfunctions. Such abnormalities are usually related to pelvic floor muscles that are either too relaxed or overly active. This lack of coordination can result in any number of bladder-related issues, collectively referred to as lower urinary tract symptoms (LUTS).
Voiding Dysfunctions In Men
A lack of bladder-urethra coordination in men is often due to some type of obstruction. For instance, some men have an enlarged prostate or an inflamed or irritated prostate gland (prostatitis) that affects urination patterns. Bladder tumors, scar tissue in the urethra (urethral strictures), and bladder stones can also create blockages that trigger a voiding dysfunction. Men may also experience issues with irregular bladder contractions because of overactive pelvic floor muscles. Men might also have symptoms that include:
- Urinary hesitancy
- Weak urine streams
- Urinary dribbling
Diagnosis
Voiding dysfunctions are often diagnosed with a series of tests to narrow down a likely cause.
This normally includes blood tests and a urinalysis to look for signs of an infection or an underlying condition.
Urination patterns may also be reviewed with a device called a uroflowmeter.
A bladder ultrasound can show how much urine is left in the bladder after voiding.
Bladder pressure is sometimes tested with a special catheter with sensors.
Treatment Options
With mild voiding issues, pelvic floor therapy may be recommended. If the main reason for a voiding dysfunction is leftover urine in the bladder, intermittent self-catheterization (ISC) is sometimes an effective way to minimize the problem. Muscle relaxants sometimes calm overactive bladder muscles enough to restore normal contraction rates. Some patients benefit from the use of a neuromodulation device that produces mild electrical impulses to correct issues with nerve signals. Treatment could also involve:
- Bladder training techniques such as double voiding
- Removal of urethral scar tissue
- Separate treatment for underlying issues (e.g., enlarged prostate, bladder stones)
- Botox injections to calm spastic bladder muscles
Some voiding dysfunctions end up going away with little or no treatment, as is often the case with urine control issues related to pregnancy or a minor infection. Bladder control problems not caused by structural issues or underlying medical conditions are sometimes manageable or avoidable with pelvic floor exercises. You may also benefit from efforts to avoid or limit foods that may trigger excessive bladder activity, including certain spicy dishes, alcoholic and carbonated beverages, sports drinks, tomato-based products, and chocolate.