Voiding Dysfunction Diagnosis by Dr Fiona Wu

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Voiding Dysfunction Diagnosis: What Patients Need to Know

Voiding dysfunction refers to difficulties in starting, maintaining, or completing urination. It can cause significant distress, affecting daily routines, work, or school life. In this video, Dr Fiona Wu, consultant urologist at R.O. Eurocare, explains how voiding dysfunction is diagnosed and what patients can expect during evaluation.

When to Seek Help

Patients often come for a urology consult when urinary symptoms begin to interfere with their quality of life. Common problems include:

• Going to the toilet very frequently, often in short intervals

• Sitting for long periods with little urine passed

• Feeling the urge to urinate again immediately after finishing

• A sensation of incomplete emptying

In some cases, patients notice red-flag symptoms such as:

• Blood in the urine (hematuria), with or without clots

• Burning pain when passing urine (dysuria)

• Lower abdominal pain linked to urination

These warning signs should not be ignored, as they may indicate underlying conditions like bladder stones, kidney stones, or tumors.

Stepwise Diagnostic Approach

Diagnosis begins with non-invasive tests before progressing to more detailed investigations if necessary.

1. Urine Tests (Urinalysis and Culture)
   These detect infections, blood cells, or inflammatory markers. If symptoms are due to a simple urinary tract infection, treatment can resolve the issue quickly.

2. Uroflowmetry
   A special test where patients urinate into a machine that records urine flow speed, volume, and leftover urine. This is painless and helps determine whether the bladder empties effectively.

3. Urodynamic Study
   If uroflowmetry is inconclusive, a more advanced test may be performed. Using small catheters in the bladder and rectum, doctors measure bladder pressure, capacity, and function during filling and voiding. This identifies whether the bladder muscle is weak or the outlet is obstructed.

4. Imaging and Cystoscopy
   If urine tests or symptoms suggest more serious conditions, scans such as CT or ultrasound may be used. A cystoscopy allows direct visualization of the bladder with a thin tube to rule out stones, tumors, or other abnormalities.

5. PSA Test (for people with a prostate)
   When patients have obstructive symptoms such as difficulty starting urination or frequent night-time urination, a prostate-specific antigen (PSA) blood test may help evaluate prostate health, including the possibility of prostate cancer.

Why Early Diagnosis Matters

Accurate diagnosis helps doctors pinpoint whether voiding dysfunction is due to infection, muscle weakness, outlet obstruction, or prostate-related issues. Once the cause is identified, patients can receive the right treatment—whether that’s antibiotics, physiotherapy, medications, or minimally invasive procedures. PRIME

Key Takeaway

Voiding dysfunction can significantly impact quality of life, but with the right diagnostic steps, effective treatment is possible. If you experience persistent urinary problems, pain, or blood in the urine, consult a urologist early for timely evaluation and care.

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