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Pelvic floor spasms in children: an unknown condition responding well to pelvic floor therapy
Piet Hoebeke1, Erik Van Laecke, Catherine Renson
1Department of Paediatric Urology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium. Piet.Hoebeke@ugent.be
Insights
Pelvic floor spasms in children cause severe nighttime pain and daytime urgency. Pelvic floor relaxation biofeedback therapy effectively treated 17 out of 21 children, with a low relapse rate.
Area of Science:
- Pediatric Urology
- Pelvic Floor Dysfunction
- Biofeedback Therapy
Background:
- Nighttime pelvic pain and urge syndrome are common in children.
- High pelvic floor activity, indicated by elevated urethral pressure, is observed during urodynamic investigations.
- Pelvic floor spasms can be secondary to detrusor overactivity.
Purpose of the Study:
- To investigate the efficacy of pelvic floor relaxation biofeedback therapy for children experiencing pelvic floor spasms.
- To assess the treatment outcomes and long-term follow-up of this therapeutic approach.
Main Methods:
- A cohort of 21 children diagnosed with symptomatic pelvic floor spasms underwent biofeedback pelvic floor relaxation therapy.
- Children with co-existing detrusor hyperactivity received concomitant anticholinergic treatment (oxybutynin).
- Therapy involved 12 weekly sessions over a mean duration of 3 months.
Main Results:
- Pelvic floor relaxation biofeedback was successful in 17 out of 21 children (81%).
- Long-term follow-up showed a relapse rate in 3 of the 17 successfully treated children.
- 10 of the 17 successfully treated children also received anticholinergic medication.
Conclusions:
- Pelvic floor relaxation therapy is an effective treatment for pelvic floor spasms in children.
- This therapy can successfully manage symptoms of nighttime pelvic pain and urge syndrome.
- The treatment shows promising results, even in cases secondary to detrusor overactivity.
Objective:
During a study period of 4 years, 21 children are seen for night time pelvic pain. These children typical wake up in the middle of the night with severe lower abdominal or perineal pain. During day some of them suffer urge syndrome. During urodynamic investigation extremely high pelvic floor activity as recorded by high urethral pressure was observed in these children. We therefore started pelvic floor relaxation biofeedback in these children.
Methods:
All children diagnosed with pelvic floor spasms underwent biofeedback pelvic floor relaxation therapy in order to learn them to counteract pelvic pain due to these spasms. In those girls in whom detrusor hyperactivity was seen on urodynamics concomitant anticholinergic treatment was given (oxybutynin).
Results:
Between January 1998 and January 2002 symptomatic pelvic floor spasms were diagnosed in 21 children (19 girls/2 boys). Pelvic floor relaxation biofeedback was successful for treatment of this condition in 17 of 21 children. Mean duration of therapy was 3 months (12 weekly sessions) and on long term follow-up relapse was seen in 3 of 17 successfully treated children. 10 of 17 successfully treated children received anticholinergics.
Conclusion:
Pelvic floor spasms in children (which can be secondary to detrusor overactivity) respond well to pelvic floor relaxation therapy.
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