Author Credentials

Katharina Mitchell, MD Chad Crigger, MD MPH Tyler Overholt, MD John Barnard, MD Tyler Trump, MD Hilary Morley MD Osama Al-Omar, MD


Dysfunctional voiding, pediatric urology, urine color


Medicine and Health Sciences | Pediatrics | Urology



Dysfunctional voiding (DV), defined as abnormal coordination between the urinary sphincter and the detrusor muscle in a neurologically intact individual, affects approximately 40% of patients that populate pediatric urology clinics. Improper hydration affects the specific gravity and concentration of urinary irritants, resulting in symptoms similar to those seen in DV patients.


Herein, we administered a validated DV survey (the Dysfunctional Voiding Symptom Score [DVSS]) and a validated dehydration severity chart (the Urine Color Chart [UCC]) to toilet trained pediatric patients and compared DV patients to patients presenting with non-urologic concerns. Data was analyzed on an item-for-item basis and by the total DVSS and UCC between the two groups. A total of 29 DV pediatric patients and 21 non-urologic pediatric patients were recruited from 2016 to 2018.


Both patient groups were equivalent with regards to age, sex, height, weight, and BMI. The DV population had significantly higher scores in 7 out of 10 individual items within the DVSS when compared to those presenting for non-urologic complaints (p < 0.05). In addition, DV patients had significantly higher total scores on the DVSS than non-urologic patients (p = 0.0004). No significant difference was noted in UCC scores between patient groups (p = 0.753). Regression analysis showed that within the dysfunctional voiding group, there was a linear relationship between DVSS and UCC scores.


The present study suggests the DVSS results yield significantly different results for DV patients when compared to age, sex, and BMI matched children with no urologic complaints. The UCC does not reliably vary between DV and non-urologic patients; however, there appears to be a linear relationship between DVSS and UCC scores within the DV cohort. Further studies may elucidate a validated metric by which DV and non-urologic pediatric patients may be differentiated.