10. Voiding symptoms

These notes are for use together with the Colley Model.

How well the patient passes urine is important. A normal flow begins without undue delay, the maximum flow is reached quickly and the flow decreases efficiently at the end of the void.

ALWAYS check that a full rectum is not contributing to the symptoms.

The following definitions are as documented in the ICS Continence Glossary (View it here)

SYMPTOMS OF A VOIDING DIFFICULTY INCLUDE:

Straining to void is the complaint of the need to make an intensive effort to either initiate, maintain or improve voiding or the urinary stream. (D’Ancona CD et al, 2019).

Slow urinary stream is the complaint of a urinary stream perceived as overall slower than previous performance or in comparison with others. (D’Ancona CD et al, 2019).

Hesitancy is the complaint of a delay in initiating voiding (when the individual is ready to pass urine). (D’Ancona CD et al, 2019).

Intermittency (intermittent stream) is the complaint of urine flow that stops and starts on one or more occasions during one voiding episode. (D’Ancona CD et al, 2019).

Terminal dribbling (dribble) is the complaint that during the final part of voiding, there is noticeable slowing of the flow to drops or a trickling stream. (D’Ancona CD et al, 2019).

References

D’Ancona CD, Haylen BT, Oelke M, Herschorn S, Abranches-Monteiro L, Arnold EP, Goldman HB, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S. An International Continence Society (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction. Neurourol Urodyn. 2019 DOI: 10.1002/nau.23897