title: Effect of biofeedback treatment on spinning top urethra in children with voiding dysfunction.
abstract: OBJECTIVE
  Spinning top urethra (STU) deformity arises secondary to detrusor instability, leading to an increase in the intravesical pressure against a closed sphincter. We retrospectively analyzed the effect of biofeedback treatment on STU in children with dysfunctional voiding.
  
  
  METHODS
  A total of 121 patients with STU and voiding dysfunction were enrolled in this study. The patients divided into two groups. Group 1 (n = 49) were treated with simple bladder retraining with timed voiding, and group 2 (n = 72) were treated with biofeedback therapy. Voiding cystourethrography was performed 6 and 12 month later to determine the status of the STU after both therapies.
  
  
  RESULTS
  The patient age range was 5 to 13 years (mean 8.1 +/- 1.9) in group 1 and 5 to 13 years (mean 8.2 +/- 1.7) in group 2. Group 1 consisted of 41 girls and 8 boys; group 2 consisted of 63 girls and 9 boys. Voiding cystourethrography revealed vesicoureteral reflux in 39 and 59 children in groups 1 and 2, respectively. The improvement rates of the biofeedback therapy in children with STU and vesicoureteral reflux were significantly greater than the children treated with timed voiding at 6 months and 1-year of follow-up.
  
  
  CONCLUSIONS
  For children admitted to urology clinics with urinary infection or complaints thought to be an unstable urinary bladder, proximal urethral dilation called STU is detected at a high frequency. It should be remembered that this situation can be related to vesicoureteral reflux and urinary bladder instability. Biofeedback training is a simple, effective, and well-tolerated treatment modality for these children.
authors.affiliation: Department of Urology, Gulhane Military Medical Academy School of Medicine, Ankara, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kibar
authors.forename: Erkan
authors.initials: E
authors.lastname: Demir
authors.forename: Cem
authors.initials: C
authors.lastname: Irkilata
authors.forename: Onder
authors.initials: O
authors.lastname: Ors
authors.forename: Faysal
authors.initials: F
authors.lastname: Gok
authors.forename: Murat
authors.initials: M
authors.lastname: Dayanc
mesh_terms: D000293:Adolescent; D001676:Biofeedback, Psychology; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic; D004576:Electromyography; D004775:Enuresis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D014521:Urethra / Q000002:abnormalities*; D001743:Urinary Bladder / Q000473:pathology; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics