Voiding Dysfunction Workup

  • Author: Christopher S Cooper, MD, FACS, FAAP; Chief Editor: Marc Cendron, MD   more...
 
Updated: Mar 5, 2010
 

Laboratory Studies

  • Urinalysis and quantitative urinary culture should be performed to evaluate for UTI. On urinalysis, the specific gravity (concentration) of the urine is noted as well as any evidence of underlying voiding problems based on the presence of hematuria, proteinuria, or glucosuria.
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Imaging Studies

  • Imaging is typically not performed. Renal or bladder ultrasonography, VCUG, radiography of the lumbosacral spine, or MRI of the lumbosacral spine may be required in select cases.
  • If dribbling and ongoing wetting have been present lifelong, evaluation should be performed for an ectopic ureter in the form of an intravenous urography.
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Procedures

  • Special equipment for uroflow, bladder ultrasound, and urodynamics are typically available only at urologic facilities.
  • Noninvasive uroflowmetry and postvoid residual urine quantification (bladder ultrasonography or scanning) are useful, noninvasive tools in evaluating children for lower urinary tract dysfunction.
  • Urodynamic testing is not usually required; however, in select cases, urodynamic studies should be performed to detect uninhibited detrusor contractions, dysfunction of the pelvic floor muscles, or a hypotonic bladder.
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Contributor Information and Disclosures
Author

Christopher S Cooper, MD, FACS, FAAP  Professor of Urology, Director of Pediatric Urology, University of Iowa, Children's Hospital of Iowa; Associate Dean for Student Affairs and Curriculum, University of Iowa Carver College of Medicine

Christopher S Cooper, MD, FACS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, International Children's Continence Society, Phi Beta Kappa, Society for Basic Urologic Research, Society for Fetal Urology, and Society for Pediatric Urology

Disclosure: Nothing to disclose.

Coauthor(s)

Kenneth G Nepple, MD  Resident Physician, Department of Urology, University of Iowa Hospitals and Clinics

Kenneth G Nepple, MD is a member of the following medical societies: Alpha Omega Alpha and American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Bartley G Cilento, Jr, MD  Instructor, Department of Surgery, Division of Urology, Children's Hospital of Boston and Harvard Medical School

Bartley G Cilento, Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Harry P Koo, MD  Chairman of Urology Division and Director of Pediatric Urology, Virginia Commonwealth University; Professor of Surgery, VCU School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond

Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Marc Cendron, MD  Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston

Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, European Society for Paediatric Urology, Johns Hopkins Medical and Surgical Association, New Hampshire Medical Society, Society for Fetal Urology, and Society for Pediatric Urology

Disclosure: Nothing to disclose.

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