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Maintenance biofeedback therapy for dysfunctional voiding: Does every child need it?

Muhammet İrfan Dönmez1, Ismail Selvi1, Elif Dereli1

  • 1Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

International Journal of Urology : Official Journal of the Japanese Urological Association
|October 28, 2022
PubMed
Summary

Biofeedback therapy (BF) effectively treats dysfunctional voiding (DV) in children, achieving 75% initial success. Maintenance BF ensures success in all patients, with higher symptom scores predicting relapse risk.

Keywords:
EMGbiofeedbackdysfunctional voidingdysfunctional voiding symptom scoremaintenance

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Area of Science:

  • Pediatric Urology
  • Rehabilitation Medicine
  • Clinical Outcomes Research

Background:

  • Dysfunctional voiding (DV) is a common pediatric urological condition.
  • Biofeedback therapy (BF) is a recognized treatment for DV.
  • Long-term outcomes and relapse rates in pediatric DV patients treated with BF require further analysis.

Purpose of the Study:

  • To evaluate the long-term clinical outcomes of biofeedback therapy (BF) in children with dysfunctional voiding (DV).
  • To identify predictors for clinical relapse and the need for maintenance BF sessions.
  • To determine the efficacy of maintenance BF in achieving sustained clinical success.

Main Methods:

  • Retrospective review of 64 children (mean age 8.89 years) with DV treated with BF (2013-2020).
  • Exclusion of patients with neurological or anatomical abnormalities.
  • Analysis of demographic data, dysfunctional voiding symptom scores (DVSS), and uroflowmetry parameters before and after initial and maintenance BF sessions.

Main Results:

  • Initial clinical success with BF was achieved in 75% of patients (48/64) after a median of 6 sessions.
  • Symptom relapse occurred in 20.8% of initially successful patients within 24 months.
  • Maintenance BF sessions led to clinical success in all patients, with higher post-initial DVSS predicting the need for maintenance.

Conclusions:

  • Biofeedback therapy demonstrates high initial efficacy for pediatric dysfunctional voiding.
  • A significant proportion of patients may experience relapse, necessitating consideration of maintenance therapy.
  • Dysfunctional voiding symptom scores after initial BF are valuable predictors for identifying patients who may require ongoing treatment.