title: High efficacy of biofeedback therapy for treatment of dysfunctional voiding in children.
abstract: BACKGROUND
  Dysfunctional voiding is a frequent condition in children associated with symptoms of incontinence. The aim of this study was to present the efficacy of biofeedback treatment on the resolution of clinical symptoms in a large cohort of children with urodynamically confirmed dysfunctional voiding.
  
  
  METHODS
  81 children (75 girls and 6 boys) aged 6-18 years (mean: 10.32 ±3.17 yrs.) with a dysfunctional voiding pattern are presented. 74/81 (92.6%) of children were unresponsive to standard urotherapy and prior pharmacotherapy. Symptoms of bladder dysfunction were evaluated by questionnaire, bladder diary and an urodynamic study according to definitions and standards set by ICCS. The biofeedback training was planned for 2 months. Each session consisted of about 30 repeats of 5 s contraction and 30 s relaxation of pelvic floor muscles and external urethral sphincter. Biofeedback was performed together with standard urotherapy.
  
  
  RESULTS
  67 (82.72%) of the 81 children declared wetting during the day and 41 (50, 62%) - wetting during the night. 32/81 (39.5%) children had increased voiding frequency and 43 (53.08%) had decreased bladder capacity. Following 2 months of biofeedback therapy daytime incontinence resolved in 34/67 (50.7%) children and nighttime incontinence in 22/41 (53.65%). A further 40,3% declared partial improvement in daytime and 26.7% in nighttime wetting.
  
  
  CONCLUSIONS
  Biofeedback treatment is an effective therapeutic option for children with dysfunctional voiding. Pelvic floor therapy with biofeedback should be offered to children with dysfunctional voiding resistant to standard urotherapy.
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Krzemińska
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Maternik
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Drożyńska-Duklas
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Szcześniak
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czarniak
authors.affiliation: Department Pediatric & Adolescent Surgery and Urology Medical University Gdańsk, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Gołębiewski
authors.affiliation: Department Pediatric & Adolescent Nephrology & Hypertension Medical University Gdańsk, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zurowska
keywords: biofeedback; children; dysfunctional voiding; incontinence