Animated Biofeedback for Pediatric Functional Voiding Dysfunction: A Systematic Review and Meta-Analysis of Postvoid...

Area of Science:

• Pediatric Urology
• Digital Health Interventions

Background:

• Pelvic floor retraining for pediatric functional voiding dysfunction often uses animated or gamified biofeedback to enhance engagement.
• The added clinical value of these advanced biofeedback methods compared to standard urotherapy or conventional biofeedback is not well-established.

Purpose of the Study:

• To systematically review and synthesize evidence on animated or gamified biofeedback for pediatric nonneurogenic functional voiding dysfunction.
• To conduct an exploratory quantitative analysis of postvoid residual (PVR) urine volume.

Main Methods:

• A systematic literature search was performed across PubMed, Cochrane Library, and ScienceDirect.
• Included were comparative studies on children with dysfunctional voiding or related conditions, analyzing PVR urine volume via meta-analysis and other outcomes narratively.

Main Results:

• Three comparative studies with 170 children were analyzed.
• Exploratory meta-analysis revealed no significant reduction in PVR urine volume with animated/gamified biofeedback versus controls (MD, -6.83 mL; p = 0.55), with high heterogeneity (I² = 89%).
• Narrative data suggested potential benefits when added to urotherapy, but no clear superiority over conventional biofeedback was found.

Conclusions:

• Current evidence is limited by small sample sizes and study heterogeneity, making pooled estimates exploratory.
• There is insufficient evidence to confirm that animated or gamified biofeedback offers additional therapeutic benefits beyond conventional biofeedback for pediatric functional voiding dysfunction.
• Larger, standardized comparative studies are necessary to validate these findings.