Functional voiding disorders in females

One hundred fifty‐nine female patients with persistent and unexplained voiding symptoms were referred for urodynamic study. Sixty percent had frequency, and nearly half of these reported incontinence. Twenty‐five percent had obstructive symptoms, and half of these had urinary retention. Symptoms were long standing (mean 12.3 years) especially in those with detrusor hyperreflexia (DH). Also, a history of childhood enuresis was elicited in 50% of patients with DH. A psychosocial disturbance or psychosomatic illness was present in 70% of our patients. Urodynamic studies revealed DH in 44.5%, detrusor areflexia (DA) in 44.5 %, and normal studies in 11 %. Rapid pharmacologic testing using bethanechol (n = 67) and/or diazepam (n = 13) was performed in patients with DA as an aid in determining the etiology. The role of urodynamic testing in evaluating and treating functional voiding disorders in adult female patients is discussed.