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

Abstract

Purpose: To compare the effectiveness of biofeedback-assisted pelvic fl oor muscle training (PFMT) and PFMT alone on voiding parameters in women with dysfunctional voiding (DV). Materials and Methods:The patients in group 1 (34 patients) were treated with biofeedback-assisted PFMT, and the patients in group 2 (34 patients) were treated with PFMT alone for 12 weeks. The 24-hour frequency, average voided volume, maximum urine fl ow rate (Q max ), average urine fl ow rate (Q ave ), post-void residual urine volume (PVR), and the validated Turkish Urogenital Distress Inventory (UDI-6) symptom scores were recorded before and after 12 weeks of treatment. Results: At the end of treatment sessions, the Q max and Q ave values of the patients in group 1 were signifi cantly higher than those in group 2, and the PVR in the patients in group 1 was signifi cantly lower than those in group 2 (p=.026, .043, and .023, respectively). The average UDI-6 symptom scores of the patients in group 1 were signifi cantly lower than those in group 2 (p=.034). Electromyography activity during voiding, in group 1 was signifi cantly lower than in group 2 (41.2 vs. 64.7, respectively, p=.009). Conclusion: Biofeedback-assisted PFMT is more effective than PFMT alone in improving clinical symptoms, urofl owmetry parameters, and EMG activity during voiding.

The effect of pelvic floor muscle training in women with functional bladder outlet obstruction

“…Although this contradicts with previous ndings [13], explains partly the non-signi cant changes of uro owmetry parameters, since many women reported multiple UTI episodes per year. A randomized controlled study compared biofeedback plus PFMT versus PFMT alone in women with VD and concluded that the former improved voiding symptoms and uro owmetry parameters compared to latter [20]. Our ndings indicated that high PVR and UTI prevalence improve after a 6-month PFMT even without biofeedback, an evidence which is in line with the literature.…”

The effect of pelvic floor muscle training in women with functional bladder outlet obstruction

“…On the other hand, in a study mainly involved children with non-neurogenic voiding dysfunction, traditional biofeedback proved to be effective only as an adjunctive treatment to PFMT [ 22 ]. A randomized controlled study compared biofeedback plus PFMT versus PFMT alone in women with VD and concluded that the former improved voiding symptoms and uroflowmetry parameters compared to latter [ 23 ]. It should be, also, important to refer that during pandemic by COVID-19, the need of distant PFMT care had been increased and several programs for women with dysfunction voiding had been based on telehealth.…”

The RISE FOR HEALTH study: Methods for in‐person musculoskeletal assessment

“…Erbes et al, 24 utilizing the same study population, found that cases with urinary urgency and frequency demonstrated greater impairment during movement tests of the hip, pelvis, and spine, urgency provocation during certain movements and tests, such as the FADIR test of the hip, and relief of symptoms with positioning compared to controls. The relationship of MSK health and voiding function has been studied in the context of hyperactivity of urethra and pelvic floor muscles, with small studies suggesting improved voiding parameters, symptoms, and quality of life with biofeedback therapy 25,26 . Additionally, gait impairment and UI severity in the elderly have been shown 27 .…”

“…The relationship of MSK health and voiding function has been studied in the context of hyperactivity of urethra and pelvic floor muscles, with small studies suggesting improved voiding parameters, symptoms, and quality of life with biofeedback therapy. 25,26 Additionally, gait impairment and UI severity in the elderly have been shown. 27 We hypothesize that findings on MSK assessments will be associated with the storage and emptying functions of the bladder.…”