不正確的使用骨盆底肌（pelvic floor）以調節尿節閉鎖功能，可能導致骨盆底肌或尿道外括約肌（urethral external sphincter）活力增強。長期慢性骨盆底肌活力增強可能導致排尿功能不良（dysfunctional voiding），便秘（constipation），骨盆腔疼痛等症狀。排尿功能不良乃用以描述神經學正常的人排尿時無法放鬆尿道外括約肌道致膀胱無法有效排空。此尿道外括約肌協調異常為後天錯誤的學習型態，常造成功能性尿道阻塞（functional obstruction）及各種下尿路症狀。排尿功能不良同時也可能是造成反覆性尿路感染（recurrent urinary tract infection），急性或慢性尿液滯留（urinary retention），或嚴重患者造成上尿路及下尿路病變的主要原因。此種骨盆底肌功能失調被視為導致功能性排尿障礙的重要病因，因此治療策略著重骨盆底肌，能有意義的改善排尿功能。尿道外括約肌為骨盆底肌的一部份，可隨意收縮，藉由骨盆底肌生物回饋（biofeedback），病人能學習控制骨盆底肌，矯正錯誤的排尿型態。最近幾年，行為修正模式（behavior modification）及生物回饋已成為排尿功能不良兒童及成年女性的建議治療模式，應用於成年男性病患也證實有良好成效。行為修正模式包括調整排尿間隔時間及飲水量（voiding-drinking schedule），飲食調節，學習良好排尿姿勢（proper toilet posture）及修正行為習慣。骨盆底肌運動（pelvic floor exercise）目的在增進骨盆底肌知覺（awareness），使病人學習正確收縮及放鬆骨盆底肌，藉由強調骨盆底肌放鬆以改善排尿障礙。此種病人多半本體感覺（proprioception）較差，無法單獨收縮骨盆底肌常錯誤收縮臀肌及腹等協同肌取代。生物回饋能輔助病人選擇性收縮骨盆底肌，以訓練骨盆底肌控制能力及協調性。電刺激治療（electrical stimulation）則有助於減輕疼痛，減輕肌肉痙攣（muscle spasm），增進骨盆底肌的知覺以改善排尿障礙。植入式薦椎神經電刺激（implantable sacral neural stimulation）可提供保守療法失敗後的另一項選擇。

Incorrect efforts to maintain urinary continence may induce urethral external sphincter or pelvic floor overcontraction and result in hypertonicity of the pelvic floor. A hypertonic pelvic floor may often contribute to dysfunctional voiding, incomplete eomptying of towel, and finally obstipation or pelvic pain. Dysfunctional voiding is an abnormality of bladder emptying in neurologically intact individuals in whom there is an increased urethral external sphincter or pelvic floor activity during voluntary voiding. This learned behavior may result in various lower urinary tract symptoms and functional obstruction. It may also be responsible for recurrent urinary tract infections, acute or chronic urinary retention and , in severe cases, upper and lower urinary tract decompensation. Dyscoordination between detrusor and urethral external sphincter during voiding disorder. A causal treatment of the urethral external sphincter appears reasonable. The urethral external sphincter, which is part of the pelvic floor , is under voluntary control and is accessible to treatment with biofeedback. Over the years, biofeedback plus behavioral modification has become the recommended treatment for dysfunctional voiding in children as weak as in women, it also proves successful in men. Behavioral modification included timed voiding at 2-hour intervals, hydration based on urine color (concentration), a high fiber diet, instruction on proper toilet posture and daily rules applied at home to improve the voiding pattern and complete emptying with voiding. Pelvic floor exercise was designed to increase the patient’s awareness of their pelvic floor musculature and to teach them how to contract and relax the muscles with a special emphasis on relaxation. Biofeedback was often used to assist pelvic floor training since most patients have difficulty in contracting their pelvic floor separately from adjacent hip and abdominal muscle group. Electrical stimulation at high frequency induces levator ani fatique and subsequent blockade of spasm-pain cycle. Sacral neuromodulation, interfering with increased afferent from urethral sphincter to inhibit pathological reflex and enable restoration of voiding reflex, was reserved for refractory condition.