Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

Adem Altunkol, Deniz Abat, Nevzat Can Sener, Mehmet Gulum, Halil Ciftci, Murat Savas, Ercan Yeni, Adem Altunkol, Deniz Abat, Nevzat Can Sener, Mehmet Gulum, Halil Ciftci, Murat Savas, Ercan Yeni

Abstract

Objective: To compare standard urotherapy with a combination of urotherapy and biofeedback sessions and to determine the changes that these therapies promote in children with dysfunctional voiding.

Patients and methods: The data of 45 patients who participated in the study from January 2010 to March 2013 were evaluated. All patients underwent urinary system ultrasonography to determine post-void residual urine volumes and urinary system anomalies. All patients were diagnosed using uroflowmetry - electromyography (EMG). The flow pattern, maximum flow rate, and urethral sphincter activity were evaluated in all patients using uroflowmetry - EMG. Each patient underwent standard urotherapy, and the results were recorded. Subsequently, biofeedback sessions were added for all patients, and the changes in the results were recorded and statistically compared.

Results: A total of forty - five patients were included, of which 34 were female and 11 were male and the average age of the patients was 8.4 ± 2.44 years (range: 5 - 15 years). After the standard urotherapy plus biofeedback sessions, the post-void residual urine volumes, incontinence rates and infection rates of patients were significantly lower than those with the standard urotherapy (p < 0.05). A statistically significant improvement in voiding symptoms was observed after the addition of biofeedback sessions to the standard urotherapy compared with the standard urotherapy alone (p < 0.05).

Conclusions: Our study showed that a combination of urotherapy and biofeedback was more effective in decreasing urinary incontinence rates, infection rates and post - void residual urine volumes in children with dysfunctional voiding than standard urotherapy alone, and it also showed that this combination therapy corrected voiding patterns significantly and objectively.

Keywords: Biofeedback, Psychology; Child; Urinary Tract Infections.

Conflict of interest statement

Conflict of interest: None declared.

Copyright® by the International Brazilian Journal of Urology.

Figures

Figure 1. Uroflowmetry-EMG image from a 7-year-old…
Figure 1. Uroflowmetry-EMG image from a 7-year-old girl before therapy.
Figure 2. The uroflowmetry - EMG image…
Figure 2. The uroflowmetry - EMG image after standard urotherapy.
Figure 3. The uroflowmetry - EMG image…
Figure 3. The uroflowmetry - EMG image after standard urotherapy plus biofeedback sessions. (All images were obtained from the same patient.)

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Source: PubMed

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