[Dynamic transperineal ultrasonography as indication criteria for biofeedback therapy in children with dysfunctional...

Area of Science:

• Pediatric Urology
• Pelvic Floor Dysfunction
• Biofeedback Therapy

Background:

• Disorders of pelvic organs' evacuation function, including difficulty in urination, constipation, incontinence, and childhood stool smearing, represent a significant medical and social challenge.
• Non-neurogenic pelvic organ dysfunction affects children, impacting their quality of life and requiring effective treatment strategies.

Purpose of the Study:

• To evaluate the efficacy of biofeedback therapy for treating non-neurogenic pelvic organ dysfunction in children.
• To introduce and validate a novel transperineal ultrasonography method for diagnosing pelvic floor paradoxical movements.

Main Methods:

• Treatment involved biofeedback therapy sessions conducted in outpatient settings.
• Diagnosis utilized traditional methods alongside a newly developed transperineal ultrasonography technique to identify signs of pelvic floor paradoxical movements.
• Ultrasound findings indicative of dysfunction included increased posterior urethrovesical angle, deviation of bladder neck and urethra, urethral shortening, and lack of volitional movement.

Main Results:

• The study included 36 children (mean age 7.2 ± 2.3 years) with non-neurogenic pelvic organ dysfunction.
• Positive treatment changes were observed in 25 children.
• Seven children fully recovered from voiding dysfunction following the treatment.

Conclusions:

• Biofeedback therapy is a reliable and non-invasive treatment for non-neurogenic pelvic organ dysfunction in children.
• The developed transperineal ultrasonography method is effective for diagnosis and does not require specialized equipment.
• The treatment approach facilitates the formation of managed urination and improves outcomes for children with voiding dysfunction.