What is Lower Urinary Tract Dysfunction?

Lower Urinary Tract Dysfunction, also known as dysfunctional voiding, is a condition that affects many children and is generally not a serious problem but is certainly a nuisance. Dysfunctional voiding is generally felt to be a dis-coordination between the bladder and the bladder outlet. The bladder will not empty effectively due to bladder muscle stiffness.

The goal of treating dysfunctional voiding is to identify which features are most prevalent. Treatment for dysfunctional voiding is then aimed at improving bladder and bowel elimination.

Signs and Symptoms

Multiple signs and symptoms can occur, and no specific pattern is unique:

  • Urinary incontinence/Leakage
  • Painful voiding (Dysuria)
  • Frequency
  • Infrequent voiding
  • Urinary tract infections
  • Urgency
  • Incomplete emptying
  • Constipation

All of these signs and symptoms reflect inefficient or uncoordinated bladder and bowel elimination.

Elimination Issues

Most children do not empty their bladders effectively and have a tendency to retain. This urinary retention occurs in two ways:

  1. Infrequent voiders: These children hardly go to the bathroom at all and may go hours without peeing.
  2. Frequent voiders: These children pee multiple times but only little bits at a time. Consequently, these children are walking around with their bladders half full.

This incomplete emptying leads to stagnation of urine with subsequent inflammation (dysuria), irritation (spasms, urgency, and frequency), incontinence (overflow or spasms) and infection.


Because the bladder & bowel share the same nerve and muscle regulation, there are frequently problems with constipation or inefficient bowel emptying. This is important to identify, since this can influence successful bladder therapy. Signs of constipation include:

  1. Hard, pebbly stool.
  2. Excessively large stool or multiple poops in a day.
  3. Bowel movements every 2-3 days or longer.

To request an appointment with a physician at St. Louis Children's Hospital, call 314.454.5437 or 800.678.5437 or email us.