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

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.

Is biofeedback-assisted pelvic floor muscle training superior to pelvic floor muscle training alone in the treatment of dysfunctional voiding in women? A prospective randomized study

“…The goal of biofeedback is to increase awareness of the function of the pelvic floor muscles and to develop better voluntary control of these muscles and the external urethral sphincter during voiding. Biofeedback is not a therapy by itself but an adjunct to PFMT in measuring the response from the contraction of the pelvic floor muscles (10,11).…”

The effect of biofeedback treatment for children with non‐neurogenic voiding dysfunction: A systematic review and meta‐analysis

“…In addition, seven studies 19,23,24,27–30 didn't provide initial values before standard treatment and one study 18 didn't report results at the endpoint of 6 or 12 months, so we could only perform qualitative analysis on them. The results are shown in Table 4.…”

“…In accordance with the PRISMA statement, the initial search identified 1113 records. After reviewing titles, abstracts, and full-texts, fifteen eligible studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] were included in our study, seven eligible studies [20][21][22]25,26,31,32 among them were included in meta-analysis.…”

Personal and familial factors associated with toilet training

“…When assessing the type of equipment used during TT, 43% of the children used a potty chair and 28.9% used the regular toilet without seat reducer and/or feet support. It is important to note that the incorrect posture while urinating and evacuating can lead to retention maneuvers and BBD (20,21). Therefore, children should always use a toilet with seat reducer and feet support, or a potty chair in order to determine a sense of security and a more physiological position to facilitate urination and evacuation.…”