Related Experiment Videos
Management of abnormal postvoid residual urine in children with dysfunctional voiding
Yusuf Kibar1, Mesut Piskin, Hasan C Irkilata
1Section of Pediatric Urology, Department of Urology, Gulhane Military Medical Academy, Ankara, Turkey. ykibar@gata.edu.tr
Insights
Biofeedback therapy combined with urotherapy significantly improved dysfunctional voiding in children. This approach reduced abnormal postvoid residual urine (PVR) and urinary tract infections (UTIs) more effectively than urotherapy alone.
Area of Science:
- Pediatric Urology
- Behavioral Therapy
- Urodynamics
Background:
- Dysfunctional voiding is common in children, often associated with abnormal postvoid residual urine (PVR).
- Standard urotherapy is a common treatment, but its efficacy can be enhanced.
Purpose of the Study:
- To evaluate the effectiveness of biofeedback therapy in conjunction with standard urotherapy for treating dysfunctional voiding in children.
- To assess the impact on postvoid residual urine (PVR) volume and urinary tract infections (UTIs).
Main Methods:
- A prospective study involving 94 children with dysfunctional voiding and abnormal PVR.
- Randomized groups: Group 1 received standard urotherapy plus biofeedback; Group 2 received standard urotherapy alone.
- Outcomes including uroflow-electromyography, UTI rates, and PVR were measured over six months.
Main Results:
- The combination therapy group showed higher rates of normal voiding patterns (80.6% vs. 56.2%) and PVR resolution (64.5% vs. 34.4%).
- Febrile urinary tract infection (UTI) rates decreased significantly in both groups, but more so with combination therapy (3.2% vs. 9.3%).
- Both treatment modalities improved outcomes, but the combination of urotherapy and biofeedback yielded superior results.
Conclusions:
- Combining standard urotherapy with biofeedback therapy offers significant improvements for children with dysfunctional voiding.
- This integrated approach is more effective in resolving PVR and reducing UTI incidence compared to urotherapy alone.
Objectives:
To evaluate the effect of biofeedback therapy on the residual urine volume in children with dysfunctional voiding.
Methods:
This prospective study was conducted in children with dysfunctional voiding associated with abnormal postvoid residual urine (PVR) from June 2002 to 2007. The children were divided randomly into 2 groups. Group 1 was treated with standard urotherapy combined with biofeedback therapy and group 2 was treated with only standard urotherapy. The outcomes of uroflow-electromyography pattern, urinary tract infection (UTI), and PVR were recorded before and at the end of sixth month of treatment.
Results:
A total of 94 patients were enrolled in this study. Groups 1 and 2 consisted of 62 and 32 patients, respectively. The voiding pattern became normal in 80.6% (50/62) and 56.2% (18/32) of patients in groups 1 and 2, respectively. The PVR resolved in 40 of 62 (64.5%) patients in group 1 and in 11 of 32 (34.4%) children in group 2. Before the treatment, UTI was noted in 22.5% of patients (14/62) in group 1 and 21.8% of patients (7/32) in group 2. After the treatment, UTI was observed in 3.2% of patients (2/62) and in 9.3% (3/32) of patients in groups 1 and 2, respectively. Although both treatment modalities changed the voiding pattern, rate of febrile UTI, and PVR positively, these outcomes were better in a combination group.
Conclusions:
The combination of standard urotherapy with the biofeedback therapy improved the results significantly.
Related Concept Videos
Urodynamic Studies: Uroflowmetry
Imaging Studies VI: Voiding Cystourethrography and Cystography
The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
Urinary Tract Infection IV: Nursing Management
Urinary Tract Calculi V: Nursing Management
Disorders of the Urinary System
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...