Dysfunctional voiding.

PURPOSE OF REVIEW: Female dysfunctional voiding (FDV) is an intermittent and/or fluctuating flow rate due to involuntary intermittent contractions of the periurethral striated or levator muscles during voiding in neurologically normal women. Despite its codified definition, because of variable causes, there is a lack of established diagnostic criteria and management. The aim of this study is to give a comprehensive, brief review of the most recent progress in the diagnosis and management of FDV.

RECENT FINDINGS: Currently, there is the need to shed light on several issues in FDV, such as the use of standardized definitions, diagnostic criteria, and treatment modalities. The evaluation of the progress on these matters within 2013 helped to define some key advances in the field of female functional voiding dysfunction and urinary retention.

SUMMARY: In 2013, many diagnostic and therapeutic questions in female voiding dysfunction remain unsolved. However, some data began to emerge. Patients with FDV did not demonstrate a difference in effortful control (effortful control is the ability to regulate one's responses to external stimuli), but did demonstrate a higher rate of surgency (surgency is a trait aspect of emotional reactivity in which a person tends towards high levels of positive affect). Toilet training method in childhood does not seem to have any long-term correlation with FDV. Training with pelvic floor physiotherapy and biofeedback still represents the first-line treatment for FDV. In the management of other causes of female voiding dysfunction, sacral neuromodulation demonstrated a satisfying long-term efficacy in the treatment of nonobstructive urinary retention.