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Biofeedback successfully cures detrusor-sphincter dyssynergia in pediatric patients
M Porena1, E Costantini, W Rociola
1Urology Department, University of Perugia, Perugia, Italy.
Insights
Voiding and bladder biofeedback effectively treats detrusor-sphincter dyssynergia in children, achieving perineal synergy and resolving symptoms. This therapy shows high success rates for enuresis, with lasting results at four-year follow-up.
Area of Science:
- Pediatric Urology
- Biofeedback Therapy
- Urodynamics
Background:
- Detrusor-sphincter dyssynergia (DSD) is a condition affecting bladder control in children.
- Achieving perineal synergy is crucial for effective voiding.
- Biofeedback offers a non-invasive approach to address functional voiding disorders.
Purpose of the Study:
- To evaluate the efficacy of voiding and bladder biofeedback in treating DSD in children.
- To assess the ability of biofeedback to establish perineal synergy.
- To determine the success rate of biofeedback in curing DSD symptoms.
Main Methods:
- 16 boys and 27 girls (4-14 years) with DSD underwent biweekly voiding biofeedback.
- Therapy involved perineal electromyography during uroflowmetry.
- Patients with enuresis and unstable bladder received additional bladder biofeedback during cystometry.
Main Results:
- Biofeedback successfully resolved DSD in all pediatric patients.
- DSD resolved significantly faster in girls compared to boys (p <0.02).
- Enuresis resolution was faster for secondary than primary enuresis (p <0.0001), with an 80% success rate at 4 years.
Conclusions:
- Voiding and bladder biofeedback is an effective treatment for DSD in children.
- The therapy successfully establishes perineal synergy and resolves DSD symptoms.
- Biofeedback demonstrates sustained efficacy in managing pediatric voiding dysfunction.
Purpose:
We assessed the efficacy of voiding and bladder biofeedback for achieving perineal synergy and curing symptoms in children with detrusor-sphincter dyssynergia
Materials And Methods:
A total of 16 boys and 27 girls 4 to 14 years old with detrusor-sphincter dyssynergia diagnosed by uroflowmetry and electromyography underwent biweekly voiding biofeedback therapy consisting of perineal floor electromyography during uroflowmetry. The 6 patients with enuresis and an unstable bladder also underwent bladder biofeedback training during cystometry. Biofeedback continued until detrusor-sphincter dyssynergia resolved. Followup consisted of electromyography and uroflowmetry 1 month after completing biofeedback training, and telephone interviews after 2 and 4 years.
Results:
Biofeedback resolved detrusor-sphincter dyssynergia in all children, although the condition disappeared significantly sooner in girls (p <0.02). Secondary enuresis disappeared significantly earlier than primary enuresis (p <0.0001). The 2-year success rate of 87.18% for enuresis decreased to 80% at the 4-year followup.
Conclusions:
Voiding and bladder biofeedback achieves perineal synergy and cures symptoms in children with detrusor-sphincter dyssynergia