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Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games.

P H McKenna1, C D Herndon, S Connery

  • 1Department of Pediatric Urology, Connecticut Children's Medical Center, Hartford, USA.

The Journal of Urology
|August 24, 1999
PubMed
Summary
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Computer game-assisted pelvic floor muscle retraining offers a new, noninvasive outpatient method for children with voiding dysfunction. This therapy significantly improves continence, constipation, and encopresis, with objective gains in uroflowmetry-electromyography and reduced residual urine.

Area of Science:

  • Pediatric Urology
  • Pelvic Floor Rehabilitation
  • Biofeedback Therapy

Background:

  • Dysfunctional voiding in children often presents with enuresis, constipation, and encopresis.
  • Traditional treatments may be invasive or less effective for certain pediatric populations.
  • Objective measures like uroflowmetry-electromyography (UEMG) are crucial for diagnosing and monitoring voiding dysfunction.

Purpose of the Study:

  • To evaluate a novel noninvasive outpatient method for pelvic muscle retraining in children.
  • To assess the efficacy of computer game-assisted biofeedback for improving voiding dysfunction symptoms.
  • To determine objective improvements in urodynamic parameters and pelvic floor muscle activity.

Main Methods:

  • A cohort of children diagnosed with voiding dysfunction underwent a pelvic floor muscle retraining program using computer game-assisted biofeedback.

Related Experiment Videos

  • Subjective improvements in diurnal enuresis, nocturnal enuresis, constipation, and encopresis were assessed via surveys.
  • Objective assessments included pre- and post-treatment UEMG and post-void residual urine volume measurements.

    • Main Results:

    • Significant subjective improvements were reported by over 80% of patients for diurnal enuresis, constipation, and encopresis by end treatment.
    • Objective improvements included enhanced UEMG patterns in 42% and decreased post-void residual urine in 57% of patients.
    • Pelvic floor muscle retraining demonstrated improved resting and contracting tone, with 78% showing better contraction post-therapy.

    Conclusions:

    • Computer game-assisted pelvic floor muscle retraining is an effective conservative management strategy for pediatric voiding dysfunction.
    • The therapy leads to substantial subjective and objective improvements in continence, bowel function, and urodynamic parameters.
    • This noninvasive approach offers a promising alternative for children experiencing complex voiding issues.