Biofeedback Training for Lower Urinary Tract Symptoms: Factors Affecting Efficacy

Abstract

Biofeedback therapy can be effective in children with dysfunctional voiding and urinary tract infection. Children with a staccato voiding pattern may require a minimum of 3 visits to improve the voiding pattern. Children who complete 3 sessions are more likely to succeed.

Objective versus subjective outcome measures of biofeedback: What really matters?

“…While our study suggests that BFB works to lower the symptom score and thus is effective, it does not address the issue of cost which can be substantial for both in our series and others [9] the number of BFB office visits ranged anywhere from 1 to 9. The next generation of BFB devices should become more portable to allow for BFB at home [15] in a more natural setting.…”

“…Protocols for BFB, which types of patients should be referred, which outcome measures should be used and how long patients should be treated, are variable among practitioners [3,9,10]. Positive clinical outcomes of BFB have included reduction in post-void residual urine, improved vesicoureteral reflux, increased bladder capacity, reduction of EMG activity during voiding, and a reduced incidence of UTIs [9,11].…”

“…Positive clinical outcomes of BFB have included reduction in post-void residual urine, improved vesicoureteral reflux, increased bladder capacity, reduction of EMG activity during voiding, and a reduced incidence of UTIs [9,11]. While these measures carry clinical significance, save for a change in the incidence of UTIs, they often mean little to the patient.…”

Urinary Tract Infections and Dysfunctional Voiding

“…showed that some parameters are able to predict the success of BFM therapy (Drzewiecki et al, 2009). The Authors noted that compliance and commitment during the treatment are both determinant factors, considering that at least 6 sessions are required for pediatric patients and that the probability of flow normalization after the third session are reduced to 5%.…”

Biofeedback in the Management of Urinary Continence in Children

“…However, EMG was not used to define the presence of dysfunctional voiding. Drzewiecki et al [18] reviewed possible factors for success in 77 children who underwent either animated or nonanimated biofeedback. Daytime and nighttime wetting was present in 61% of patients prior to treatment.…”