From the Research
Dysfunctional voiding caused by constipation leading to dysuria is uncommon in adults, though it can occur, and management should prioritize treating the underlying constipation and ruling out other common causes of dysuria. This condition is much more frequently seen in children, where the relationship between constipation and urinary symptoms is well-established 1, 2. In adults, when constipation does contribute to urinary symptoms, it typically happens because a severely impacted rectum can physically compress the bladder or urethra, potentially causing incomplete emptying, urinary retention, or painful urination.
Some key points to consider in the management of constipation-related dysfunctional voiding in adults include:
- Treating the underlying constipation through increased fluid intake (2-3 liters daily), dietary fiber (25-30g daily), regular physical activity, and establishing consistent bowel habits 3
- Using over-the-counter stool softeners like docusate sodium (100mg twice daily) or osmotic laxatives such as polyethylene glycol (17g daily in water) to help resolve severe constipation 3
- Ruling out other more common causes of painful urination, including urinary tract infections, interstitial cystitis, prostatitis in men, or genitourinary syndrome of menopause in women, as these conditions are more likely explanations for dysuria in adults than constipation-related dysfunctional voiding 4, 5
According to the most recent study on dysuria evaluation and differential diagnosis in adults, a targeted history and physical examination, along with urinalysis and urine culture, are essential in determining the cause of dysuria 4. The study highlights the importance of considering various causes of dysuria, including infectious and non-infectious causes, and emphasizes the need for a thorough evaluation to guide appropriate treatment.
In terms of specific treatment options, the study on fiber and macrogol in the therapy of chronic constipation suggests that a combination of psyllium and polyethylene glycol (PEG) may be an effective therapeutic option for patients suffering from chronic constipation 3. However, it is essential to note that the management of constipation-related dysfunctional voiding should be individualized and based on the specific needs and circumstances of each patient.
Overall, while dysfunctional voiding caused by constipation leading to dysuria is uncommon in adults, it is essential to consider this condition in the differential diagnosis of dysuria and to prioritize treating the underlying constipation and ruling out other common causes of dysuria.