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Published on: August 14, 2019
Biofeedback in the management of urinary continence in children
1Division of Pediatric Urology, Schneider Children's Hospital of the North Shore-Long Island Jewish Health System, 1999 Marcus Avenue, Lake Success, NY, 11042, USA. lpalmer@nshs.edu
Insights
Biofeedback therapy has advanced significantly for treating pediatric voiding dysfunction and incontinence. This technique helps children gain bladder control by improving coordination between the detrusor muscle and external sphincter.
Area of Science:
- Pediatric Urology
- Urodynamics
- Behavioral Therapy
Background:
- Pediatric voiding dysfunction and incontinence present significant social challenges.
- Dysfunctional voiding, characterized by detrusor-sphincter discoordination, is a common cause of incontinence.
- Biofeedback, introduced in 1979, has seen a resurgence in the late 1990s for managing these conditions.
Purpose of the Study:
- To review the advancements in bladder control and management of pediatric voiding dysfunction.
- To highlight the role and effectiveness of biofeedback in treating pediatric incontinence.
- To discuss the evolution from non-animated to animated biofeedback.
Main Methods:
- Review of biofeedback techniques for pediatric voiding dysfunction.
- Description of non-animated biofeedback (electromyographic tracing/auditory feedback).
- Introduction of animated biofeedback for enhanced patient understanding.
Main Results:
- Biofeedback is highly effective in treating incontinence due to dysfunctional voiding in children.
- It has also shown success in managing giggle incontinence.
- Biofeedback aids in the resolution of vesicoureteral reflux.
Conclusions:
- Biofeedback is a valuable tool for correcting pediatric incontinence and voiding dysfunction.
- Animated biofeedback offers a more intuitive approach to modulate physiological events.
- This therapeutic modality shows promise in improving outcomes for various pediatric urological conditions.
Abstract:
Significant progress has been made over the past 15 years regarding the development of bladder control and the evaluation and management of pediatric voiding dysfunction. Incontinence is a problem of significant social consequence that is commonly due to dysfunctional voiding (ie, discoordination between the detrusor and the external sphincter). Biofeedback was introduced in 1979 but was relatively forgotten until the late 1990 s. Nonanimated biofeedback relates sphincter activity to electromyographic activity as reflected as tracing on a computer screen or auditory feedback. This successful modality was exclusively available until recently when animated biofeedback became available, allowing for a more rapid grasp of the physiologic event to be modulated. Biofeedback has been shown to be very effective in children to correct incontinence secondary to dysfunctional voiding, as well as in treating giggle incontinence and to help resolve vesicoureteral reflux.
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