Female Voiding Dysfunction: a Practical Approach to Diagnosis and Treatment

Abstract

In this review, we examined a practical approach to diagnosis and treatment of voiding dysfunction in female patients. This field of urogynaecology has been the subject in many studies over the last few decades, but despite that, there is no universally accepted algorithm for diagnosis and treatment of this condition. This is primarily related to a lack of standardised definition of different types of voiding dysfunction. The International continence society (ICS) and International Urogynecology Association (IUGA) have created a joint document on terminology of female pelvic floor dysfunction. However, voiding symptoms are frequently a poor guide to objective voiding dysfunction and are frequently present in storage problems. Some authors have suggested using nomograms for either uroflowmetry or pressure flow studies. These are not widely used in current practice around the world. Diagnosis and treatment of female voiding dysfunction are based on a thorough history and examination along with appropriate investigations. Treatment should be individualised and always starts with non-invasive and conservative options followed by introduction of pharmacotherapy and lastly surgery. There is need for more research in defining female voiding dysfunction and a standardised classification. This can bring more consistency in treatment and follow up.