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Home uroflowmetry biofeedback in behavioral training for dysfunctional voiding in school-age children: a randomized
Aart J Klijn1, Cuno S P M Uiterwaal, Marianne A W Vijverberg
1Department of Pediatric Urology, University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. a.j.klijn@umcutrecht.nl
The Journal of Urology
|May 16, 2006
Summary
Home uroflowmetry biofeedback shows promise in treating voiding disorders in children with nonneurogenic bladder-sphincter dyssynergia. This adjunctive therapy may help reduce symptoms like urinary tract infections and incontinence.
Area of Science:
- Pediatric Urology
- Behavioral Therapy
- Urodynamics
Background:
- Dysfunctional voiding due to nonneurogenic bladder-sphincter dyssynergia (NNBSD) is a common cause of recurrent urinary tract infections and incontinence in children.
- The role of biofeedback using home uroflowmetry for NNBSD in children is not well understood.
- Multicomponent behavioral training programs are standard for managing these conditions.
Purpose of the Study:
- To evaluate the added value of home uroflowmetry for biofeedback training compared to added attention (video instructions) and standard therapy in children with voiding disorders.
- To assess the efficacy of home uroflowmetry biofeedback as an adjunctive treatment for dysfunctional voiding due to NNBSD.
Main Methods:
- A randomized controlled trial was conducted with 143 school-age children (6-16 years) diagnosed with NNBSD.
- Participants were randomized into three groups: standard therapy, standard therapy with home video instructions, and standard therapy with home uroflowmetry biofeedback.
- The primary outcome was total relief of complaints (urinary tract infections and incontinence) at 12 months post-randomization.
Main Results:
- Intent-to-treat analysis showed no statistically significant difference in total relief between standard treatment (44%) and added video instruction (42%).
- The group receiving home uroflowmetry biofeedback demonstrated a higher total relief rate (55%) compared to standard therapy, though not statistically significant (RR 1.24).
- Per-protocol analysis indicated that home uroflowmetry biofeedback was associated with better total relief compared to pooled standard therapy and video instruction groups (RR 1.40).
Conclusions:
- Home uroflowmetry biofeedback appears to be a beneficial adjunctive treatment for reducing symptoms in children with dysfunctional voiding due to NNBSD.
- This approach may offer an effective addition to standard behavioral therapy for pediatric voiding disorders.
- Further research may clarify the statistical significance and optimal application of home uroflowmetry biofeedback.