Pelvic floor muscle training alone or in combination with oxybutynin in treatment of nonmonosymptomatic enuresis. A randomized controlled trial with 2-year follow up

Abstract

Objective To compare the results of the standard urotherapy alone and associated with pelvic floor muscle training alone, and in combination with oxybutynin in treatment of nonmonosymptomatic nocturnal enuresis. Methods A total of 38 children aged 5 to 10 years were randomized into three groups: Group I (n=12) that was submitted to standard urotherapy; Group II (n=15), standard urotherapy associated with pelvic floor muscle training; and Group III (n=11), standard urotherapy associated with pelvic floor muscle training and oxybutynin; the treatment lasted 12 weeks. The assessment tools used were playful bladder diary, and a 48-hour bladder diary, before and after treatment. After 2 years, patients were assessed by telephone using a standardized questionnaire. Results The data of children from the three groups were homogeneous at baseline. After 12-week treatment, all children showed improved symptoms and signs of nonmonosymptomatic nocturnal enuresis, but the differences were not significant among the groups. After 2 years, the three groups showed maintenance of treatment results, but no differences among them. Conclusion All treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms, but the sample was not large enough to show differences among groups.

Traditional and innovative interventions in the management of enuresis

“…Standard urotherapy consisted of behavioural modification, proper voiding posture, bowel habits, and voiding intervals at every 2 hours, while pelvic floor exercises were 2 series of 10 maximal effort pelvic floor muscle contractions, totalling 20 contractions per session with a electromyography biofeedback. They showed no difference in treatment results, also after 2 years, documenting that all treatment modalities were effective regarding improved enuresis and lower urinary tract symptoms [ 62 ]. Vesna et al reported after one year of therapy a significantly larger number of cured children, who suffered from urinary incontinence and NE, if subjected to diaphragmatic breathing and pelvic floor muscles, while Van Kampen et al established no beneficial effect of including pelvic floor muscle training in full-spectrum therapy [ 59 , 63 , 64 ].…”

Image Enhancement Algorithm-Based Ultrasound on Pelvic Floor Rehabilitation Training in Preventing Postpartum Female Pelvic Floor Dysfunction

“…At present, there have been many reports on the study of ultrasound image diagnosis for postpartum female patients with FPFD, and there are endless studies on pelvic floor rehabilitation for this type of disease [ 17 ]. Pelvic floor ultrasound is a commonly used clinical imaging method.…”