The effect of biofeedback treatment on voiding and urodynamic parameters in children with voiding dysfunction.
OBJECTIVE
We studied the effects of biofeedback treatment on voiding and urodynamic parameters in children with voiding dysfunction.


METHODS
We prospectively studied 188 children between June 1998 and November 2003. Biofeedback was performed with a urodynamics processor that enables simultaneous recording of urine flow and electromyography, and visual display of flow/electromyography activity. At the beginning of the study this treatment was performed once weekly. After patients understood the concept and performed homework regularly sessions were scheduled at 3 to 4-week intervals and continued for 6 months. All children were evaluated at 6 months and again at 2 years after completing biofeedback training.


RESULTS
The number of the children completing biofeedback was 168 (89.4%). Improvement was obtained in all parameters, ranging from 59.2% to 87.8% at 6 months. Maximum improvement was acquired with flattened voiding in 65 of 74 children (87.8%), whereas the least improvement was acquired with daytime wetting in 58 of 98 children (59.2%). These improvements continued at 2-year followup, and ranged from 53.1% to 87.3%. While the rate of improvement for nocturnal enuresis, staccato voiding, detrusor-sphincter dyssynergia, vesicoureteral reflux and urinary tract infection had increased, the remaining parameters had decreased at 2-year followup.


CONCLUSIONS
Biofeedback training is a simple, effective and well tolerated treatment modality in children for various parameters resulting from bladder dysfunction. Motivation and willingness to participate in biofeedback treatment are important selection criteria.
Yagci
Sezgin
S
Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey.
Kibar
Yusuf
Y
Akay
Ozan
O
Kilic
Selim
S
Erdemir
Fikret
F
Gok
Faysal
F
Dayanc
Murat
M
D000293:Adolescent; D001676:Biofeedback, Psychology / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D010349:Patient Compliance; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology; D014555:Urination Disorders / Q000175:diagnosis* / Q000628:therapy*; D014563:Urodynamics / Q000502:physiology