Different symptoms can be experienced through voiding. Learn more about each below:
Hesitancy means difficulty in initiating voiding when the child is ready to void.
Straining means the child complains of needing to make an intense effort to increase intraabdominal pressure (e.g. Valsalva) in order to initiate and maintain voiding.
Weak Stream describes an observed stream or uroflow that is weak.
Intermittency implies micturition that is not continuous but rather has several discrete stop and start spurts.
Dysuria is the complaint of burning or discomfort during micturition. The timing of dysuria may be noted during voiding. Dysuria at the start of voiding suggests the urethral as the source of pain, whereas dysuria at the completion of voiding suggests the bladder being the source.
Holding Maneuvers are observable strategies used to postpone voiding or suppress urgency that may be associated with bladder overactivity. The child may or may not be fully aware of the purpose of these maneuvers, but they are usually obvious to caregivers. Common behaviors include standing on tiptoes, forcefully crossing the legs, grabbing or pushing on the genitals or abdomen and placing pressure on the perineum (e.g. squatting with the heel pressed into the perineum or sitting on the edge of a chair)
Feeling of incomplete emptying refers to the complaint that the bladder does not feel empty after voiding and may result in the need to return to the toilet to void again.
Urinary retention refers to the sensation of an inability to void despite persistent effort in the presence of a fully, distended bladder. Duration of time is particularly beneficial in characterizing retention.
Voiding postponement is defined as a habitual postponement of micturition using holding maneuvers, it can represent a symptom in healthy children and as a condition in children with LUTD.