Infrequent Voiding Syndrome

Infrequent voiding syndrome, also known as lazy bladder syndrome, refers to the constellation of findings in patients who voluntarily delay voiding, resulting in large-capacity urinary bladders with weak or absent detrussor contractile function. Patients may present with urinary leakage, urinary tract infections, abdominal pain, palpable pelvic mass, increased work of voiding and a weak urinary stream, or constipation.

Voiding cystourethrogram reveals an enlarged and smooth-walled urinary bladder, with a large post-void residual. Scout views may reveal a large amount of fecal material.

The case presented here is from a teenager with frequent urinary tract infections. The scout view shows a moderate amount of stool in the colon. We see a large (500-cc capacity), smooth-walled urinary bladder with a small right-sided diverticulum (arrow) and no significant post-void residual.

A rough guide for determining normal urinary bladder volumes:
You can then multiply by 30 to get a rough estimate in normal (SI) units.

Equations made with the online LaTeX equation editor.

References

• Kaefer M, Zurakowski D, Bauer SB, Retik AB, Peters CA, Atala A, Treves ST. Estimating normal bladder capacity in children. J Urol. 1997 Dec;158(6):2261-4.
• Lalli AF, Thornbury JR, Lapides J. Large capacity smooth-walled bladders as an indication of the infrequent voiding syndrome. J Urol. 1971 May;105(5):662-3.