How to Diagnose Dysfunctional Voiding

This review aims to discuss the diagnosis and assessment of dysfunctional voiding in both children and adults.

Although the pillars of diagnosing dysfunctional voiding are a history, physical exam, and uroflowmetry with electromyography or urodynamics, new technology may aid in this evaluation. The use of urinary biomarkers may be a helpful, non-invasive adjunct in diagnosis. In addition, novel devices and smartphone apps may make diagnosis more accessible to patients and providers.

Dysfunctional voiding refers to the condition where there is a lack of coordination between the sphincter and detrusor muscle during bladder emptying in the absence of anatomic or neurologic cause. Commonly diagnosed in children, this condition may persist or be diagnosed de novo in adulthood. As such, thorough evaluation is critical to diagnosis to prevent recurrent infections and deterioration of the upper urinary tract. Uroflowmetry, with or without electromyography, and/or urodynamics remain the gold standard for diagnosis, while new technology may facilitate evaluation.