The effectiveness of biofeedback therapy in children with monosymptomatic enuresis resistant to desmopressin treatment

Abstract

Objective: To investigate the effect of biofeedback therapy on children with desmopressin-resistant primary monosymptomatic enuresis (MsE). Material and methods:The study comprised both retrospective and prospective sections. A total of 262 medical files of patients who were diagnosed as enuresis between November 2012 and January 2015 were retrospectively screened. Patients with neuropathic bladder, daytime voiding problems, anatomical pathology and enuresis-related diseases were excluded from the study. The demographic data and family characteristics of 29 children with desmopressin-resistantprimary MsE were recorded. After biofeedback treatment patients whose frequency of enuretic episodes decrease by more than 50% were included in the successful biofeedback treatment group (SBTG), while other patients were categorized in the unsuccessful biofeedback treatment group (USGBT). The outcomes of uroflowmetry, voided volume, postvoiding residue (PVR) and total bladder volume/age-adjusted normal bladder capacity (TBV/NBC) were recorded before and at the sixth month of the treatment.

The impact of motivational therapy in the management of enuretic children

“…Since enuresis is a disorder characterized by a deep impact on psychological, behavioral and social functioning of the child, it can benefit from a MT approach. [13][14][15][16][17][18][19][20] Our study focused on the role of MT in enuretic children undergoing pharmacological treatment or not, and its potential positive effects.…”

Effectiveness of Intra-anal Biofeedback and Electrical Stimulation in the Treatment of Children With Refractory Monosymptomatic Nocturnal Enuresis: A Comparative Randomized Controlled Trial

“…They concluded that animated BF games played an essential role in entertaining children, such that contraction and relaxation of the external sphincter more rapidly resulted in improved vesico-sphincter coordination and a significant reduction in wet night episodes. Moreover, biofeedback PFMs training modulates bladder instability by stimulating the detrusor inhibitory reflex, leading to improvement of the bladder capacity and bladder tone modulation [13].…”

“…In addition to behavioral therapy, all children in the 3 groups underwent PFMs training using Kegel exercises. Children were instructed to practice 3 sets of 30 repetitions of PFMs training in the crook-lying position with 10 seconds of contraction and 10 seconds of relaxation for 30 minutes without activating the hip or abdominal muscles [10,13]. All children underwent 3 sessions per week under the therapist’s supervision and as a home routine on the other days for 3 successive months.…”

“…Biofeedback PFMs training is effective for the treatment of pelvic floor disorders. It controls enuresis frequency and normalizes bladder capacity through enhancing PFMs function and sphincteric neuromotor control [13]. Biofeedback (BF) training with anal pressure monitoring is a technique used in PFMs training [10].…”

Biofeedback in the treatment of lower urinary tract symptoms in children

“…Pelvic-floor exercise consists of tightening the pelvic muscles and holding the contraction for a period of time, followed by a resting period [11]. These changes in the electrical muscle activity are transformed into visual and audio signals [12,13]. Using surface electrodes to identify changes in muscle activity, the user is visually or audibly warned [12].…”