Related Experiment Video
Updated: Jul 14, 2026
Real-time fMRI Biofeedback Targeting the Orbitofrontal Cortex for Contamination Anxiety
Published on: January 20, 2012
The optimal number of sessions for biofeedback therapy in children: A retrospective study
1Department of Pediatric Urology, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkiye.
Insights
Biofeedback therapy is effective for functional voiding dysfunction in children, with an average of 6 sessions needed for improvement. Younger children and females tend to respond faster to this non-invasive treatment.
Area of Science:
- Pediatric Urology
- Rehabilitation Medicine
- Bioengineering
Background:
- Functional voiding dysfunction (FVD) affects many children, impacting their quality of life.
- Standard urotherapy and behavioral therapy are first-line treatments for FVD.
- Biofeedback electromyography (EMG) offers a non-invasive approach to retrain pelvic floor muscles.
Purpose of the Study:
- To determine the optimal number of biofeedback therapy sessions for treating functional voiding dysfunction in children.
- To identify factors influencing treatment response and duration.
Main Methods:
- Retrospective analysis of 779 pediatric patients undergoing biofeedback therapy for FVD.
- Inclusion criteria: referred for urinary symptoms, uroflow/EMG findings, non-response to standard therapies, and completion of at least 8 sessions.
- Utilized EMG biofeedback, pelvic muscle training, and symptom diaries; analyzed data using Mann-Whitney U and Chi-Square tests.
Main Results:
- The average number of biofeedback sessions for a therapeutic response was 6 ± 1.3.
- Female patients (62.4%) and younger children showed significantly earlier and better responses to therapy.
- Patients not responding to therapy were older and required more sessions (p<0.05).
Conclusions:
- Biofeedback is an effective, non-invasive treatment for pediatric functional voiding dysfunction.
- Symptomatic improvement is typically observed within 1.5-2 months (average 6 sessions).
- Younger children and females generally experience better and faster outcomes; males may require longer treatment durations.
Objective:
Biofeedback electromyography (EMG) involves the transmission of pelvic and abdominal muscle activity to the patient via visual and sometimes auditory feedback, with the ultimate goal of learning to contract and relax the pelvic muscles at the appropriate times through real-time analysis and feedback. To determine the optimal number of biofeedback therapy sessions required for a therapeutic response in the treatment functional voiding dysfunction.
Methods:
The retrospective data of 779 patients who underwent biofeedback therapy at a tertiary pediatric hospital between 2017 and 2023 were analyzed. The study included patients referred for urinary symptoms and uroflow/EMG findings who did not respond to standard urotherapy and behavioral therapy and completed at least 8 biofeedback sessions. During treatment, methods such as EMG biofeedback, pelvic muscle training, and keeping symptom diaries were utilized. Statistical analyses were performed using the Mann-Whitney U test and Chi-Square test.
Results:
Of the patients, 62.4% were female, 37.6% were male, and the mean age was 9.05±3.05 years. The most common urinary symptoms were daytime urinary incontinence (59.4%) and nocturnal enuresis (54%). The average number of sessions required for a therapeutic response was 6±1.3. Female patients showed an earlier response to treatment compared to males (p<0.01). Younger patients demonstrated faster recovery and better response to therapy (p<0.05). Patients who did not respond to therapy had a higher mean age and required more sessions (p<0.05). The higher mean number of sessions in non-responders compared to responders was found to be statistically significant (p=0.001; p<0.05).
Conclusion:
Biofeedback is an effective and non-invasive treatment method for children with functional voiding dysfunction. Most patients show symptomatic improvement within 1.5-2 months (2-8 sessions - average 6). Male patients may require longer treatment durations, while younger children respond better to therapy. Future studies focusing on factors influencing biofeedback success may contribute to optimizing this treatment.
