title: Biofeedback successfully cures detrusor-sphincter dyssynergia in pediatric patients.
abstract: OBJECTIVE
  We assessed the efficacy of voiding and bladder biofeedback for achieving perineal synergy and curing symptoms in children with detrusor-sphincter dyssynergia
  
  
  METHODS
  A total of 16 boys and 27 girls 4 to 14 years old with detrusor-sphincter dyssynergia diagnosed by uroflowmetry and electromyography underwent biweekly voiding biofeedback therapy consisting of perineal floor electromyography during uroflowmetry. The 6 patients with enuresis and an unstable bladder also underwent bladder biofeedback training during cystometry. Biofeedback continued until detrusor-sphincter dyssynergia resolved. Followup consisted of electromyography and uroflowmetry 1 month after completing biofeedback training, and telephone interviews after 2 and 4 years.
  
  
  RESULTS
  Biofeedback resolved detrusor-sphincter dyssynergia in all children, although the condition disappeared significantly sooner in girls (p <0.02). Secondary enuresis disappeared significantly earlier than primary enuresis (p <0.0001). The 2-year success rate of 87.18% for enuresis decreased to 80% at the 4-year followup.
  
  
  CONCLUSIONS
  Voiding and bladder biofeedback achieves perineal synergy and cures symptoms in children with detrusor-sphincter dyssynergia
authors.affiliation: Urology Department, University of Perugia, Perugia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Porena
authors.forename: E
authors.initials: E
authors.lastname: Costantini
authors.forename: W
authors.initials: W
authors.lastname: Rociola
authors.forename: E
authors.initials: E
authors.lastname: Mearini
mesh_terms: D000293:Adolescent; D001259:Ataxia / Q000503:physiopathology / Q000628:therapy*; D001676:Biofeedback, Psychology; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D004775:Enuresis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001745:Urinary Bladder Diseases / Q000503:physiopathology / Q000628:therapy*; D014555:Urination Disorders / Q000628:therapy*; D014563:Urodynamics