Pelvic floor spasms in children: an unknown condition responding well to pelvic floor therapy.
OBJECTIVE
During a study period of 4 years, 21 children are seen for night time pelvic pain. These children typical wake up in the middle of the night with severe lower abdominal or perineal pain. During day some of them suffer urge syndrome. During urodynamic investigation extremely high pelvic floor activity as recorded by high urethral pressure was observed in these children. We therefore started pelvic floor relaxation biofeedback in these children.


METHODS
All children diagnosed with pelvic floor spasms underwent biofeedback pelvic floor relaxation therapy in order to learn them to counteract pelvic pain due to these spasms. In those girls in whom detrusor hyperactivity was seen on urodynamics concomitant anticholinergic treatment was given (oxybutynin).


RESULTS
Between January 1998 and January 2002 symptomatic pelvic floor spasms were diagnosed in 21 children (19 girls/2 boys). Pelvic floor relaxation biofeedback was successful for treatment of this condition in 17 of 21 children. Mean duration of therapy was 3 months (12 weekly sessions) and on long term follow-up relapse was seen in 3 of 17 successfully treated children. 10 of 17 successfully treated children received anticholinergics.


CONCLUSIONS
Pelvic floor spasms in children (which can be secondary to detrusor overactivity) respond well to pelvic floor relaxation therapy.
Department of Paediatric Urology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Piet.Hoebeke@ugent.be
Piet
P
Hoebeke
Erik
E
Van Laecke
Catherine
C
Renson
Ann
A
Raes
Joke
J
Dehoorne
Pieter
P
Vermeiren
Johan
J
Vande Walle
D001676:Biofeedback, Psychology / Q000379:methods*; D002648:Child; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D017773:Pelvic Floor; D017699:Pelvic Pain / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies; D014555:Urination Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D014563:Urodynamics