Voiding Disorders

What are the treatment options for voiding disorders?

• Prevention and early recognition: Prevention of voiding disorders is important. After pelvic or continence surgery, the use of temporary catheterisation can prevent immediate post-operative bladder overdistension. Early recognition of postnatal urinary retention and early catheterisation is crucial to early return of normal urinary function subsequently.
• Medication: Drugs may be used to treat the underlying cause of the voiding disorders. A course of antibiotics or antiseptic may be used if there is an infection. In patients with anxiety disorders, a small dose of anti-anxiety medication or sleeping tablets may help. Vaginal oestrogen pessaries may be used if atrophic changes are implicated in the voiding difficulties. Some drugs may be used to improve bladder muscle contraction.
• Clean Intermittent Self Catherisation (CISC): In CISC, the patient is taught to insert a urinary catheter under clean conditions at regular intervals. This procedure is easy to learn. The use of CISC enables many women to live normal lives with efficient bladder emptying, free from discomfort and distress. For patients not willing or unsuitable to use CISC, indwelling catheters may be used.
• Surgical treatment: In cases where the urethral opening is narrowed, it may be dilated using metal rods called Hegar dilators. However, the main disadvantage is that voiding difficulty may recur following healing and scarring of the dilated area. Often, repeated dilatations are needed. If the woman is having bladder or uterine prolapse, it should be dealt with surgically.

Conclusion

Voiding disorders are common in women. If left unrecognised, it may lead to permanent damage to the bladder and kidneys. Hence treatment should be started early and the causes dealt with promptly.