Role of behavioral changes and biofeedback in urology

Voiding disorders are common in urological patients. Pelvic floor dysfunction may result from overtraining pelvic floor muscles in an attempt to prevent leaking. This can further cause bladder dysfunction or weakening the pelvic floor muscles. Pelvic floor dysfunction or insufficient relaxation of the pelvic floor results in hesitancy, intermittency, and high postvoid residuals (PVR). Behavioral changes and biofeedback play a key role in urologic problems including pelvic pain, irritative voiding symptoms, recurrent urinary tract infections, and incontinence. Biofeedback involves using electrodes to transduce muscle potentials into auditory or visual signals; patients learn to increase or decrease voluntary muscle activity. Conservative behavioral and biofeedback treatments are safe and effective interventions that should be more readily available to patients as a first-line treatment for voiding dysfunction. Patient education may take time but has higher long-term success and makes the patient more responsible and less passive regarding their condition.