Biofeedback as a first-line treatment for overactive bladder syndrome refractory to standard urotherapy in children.
BACKGROUND
Overactive bladder syndrome (OAB) and dysfunctional voiding (DV) are subgroups of lower urinary tract dysfunction (LUTD). Standard urotherapy is the first-line treatment option of OAB in children.


OBJECTIVE
The aim was to investigate the use of biofeedback as a first-line treatment option in OAB refractory to standard urotherapy, and determine the factors affecting efficacy.


METHODS
Between 2005 and 2015, we retrospectively analyzed a total of 136 hospital records of children with OAB who had not previously used any anticholinergics and were refractory to standard urotherapy. Patients with urgency and/or urge incontinence and/or making holding maneuvers to suppress urgency were defined as having OAB symptoms, and resolution of these complaints was defined as successful biofeedback therapy.


RESULTS
Seventy-three of 136 OAB patients' urgency recovered by biofeedback therapy with the success rate of 53% (p < 0.001). Sixty-two of 101 patients with holding maneuvers (success rate 61%) (p < 0.001), 70 of 101 patients with urgency incontinence (success rate 69%) (p < 0.001), 76 of 114 patients with daytime incontinence (success rate 66%) (p = 0.023), 87 of 97 patients with enuresis (success rate 89%) (p = 0.009), and 27 of 39 patients with dysuria (success rate 69%) (p = 0.007) recovered from their symptoms significantly. The mean lower urinary tract symptom score (LUTSS) was 16.38 and 8.18 before and after biofeedback therapies, respectively (p < 0.001) (Table). Patients without holding maneuvers (p = 0.045), daytime incontinence (p = 0.030), and enuresis (p = 0.045) had better recovery compared to the opposites.


CONCLUSIONS
Biofeedback can be thought of as the first-line treatment option when standard urotherapy fails in children with OAB.
Etimesgut Military Hospital, Department of Urology, Ankara, Turkey.
Turgay
T
Ebiloglu
Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey.
Engin
E
Kaya
Konya Military Hospital, Department of Urology, Konya, Turkey. Electronic address: dr_burak83@yahoo.com.
Burak
B
Köprü
Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey.
Bahadır
B
Topuz
Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey.
Hasan Cem
HC
Irkilata
Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey.
Yusuf
Y
Kibar
D000293:Adolescent; D001676:Biofeedback, Psychology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013577:Syndrome; D053201:Urinary Bladder, Overactive / Q000628:therapy*
Biofeedback; Children; Overactive bladder syndrome; Treatment