title: [Animated biofeedback for the dysfunctional voiding syndrome].
abstract: OBJECTIVE
  To analyze clinical and electromyographic treatment outcome of dysfunctional voiding (DV) with animated Biofeedback (Bfb). Clinical or electromyographic variables associated with higher success rate were checked.
  
  
  METHODS
  Cross-sectional study of patients with DV, that in 2010- 2015 followed animated Bfb program. Efficacy was measured with Uroflowmetry, Electromyography (EMG) and validated clinical questionnaire. Inclusion criteria: no myelodysplasia, no anatomical malformations and a minumin of 3 Bfb sessions. Clinical variables: age, number of sessions, daytime leaks, nocturnal enuresis, constipation, UTI, VUR. Flow measurement variables: morphology of curves, electromyogram, flows, and elevated post void residual (PVR).
  
  
  RESULTS
  Of 37 patients who received Bfb, 27 girls who met inclusion criteria were selected. Mean age: 7.8 years (2.5). Twelve (44%) had detrusor overactivity on urodynamics concomitantly. Globally, all clinical and flowmetry parameters improved. Clinically 33.5% had complete resolution of symptoms, 37% improved (> 50% of symptoms according to criteria ICCS) and 29% had no improvement. In EMG, 74% achieved normal perineal relaxation. Constipation at baseline is associated with lower rates of success (cure: 13 vs. 58%, p = 0.019; cure + improvement: 60% vs. 83% p> 0.05). The absence of RPM at the end of the study was associated with clinical improvement (cure: 66.7% vs. 0%, p = 0.012; cure + improvement: 89% vs. 60%, p> 0.05).
  
  
  CONCLUSIONS
  Bfb in DV provides cure or improvement and electromyographic resolution are 69 and 74% respectively. The absence of constipation is associated with higher success rates. The High RPM correlates with persistence of clinics.
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: M
authors.initials: M
authors.lastname: Fernández Ibieta
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Guirao Piñera
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: G
authors.initials: G
authors.lastname: Zambudio Carmona
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: J
authors.initials: J
authors.lastname: Rojas Ticona
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: I
authors.initials: I
authors.lastname: Martínez Castaño
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: V
authors.initials: V
authors.lastname: Villamil
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Sánchez
authors.affiliation: DUE Unidad Pruebas Funcionales, Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: A
authors.initials: A
authors.lastname: García López
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: P
authors.initials: P
authors.lastname: Reyes Ríos
authors.affiliation: Servicio Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.
authors.forename: J I
authors.initials: JI
authors.lastname: Ruiz Jiménez
mesh_terms: D001676:Biofeedback, Psychology; D002648:Child; D003248:Constipation; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*; D014555:Urination Disorders / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics
keywords:  Postvoidal residual; Biofeedback; Disfunctional voiding