Is urotherapy alone as effective as a combination of urotherapy and biofeedback in children with dysfunctional voiding?

Vol. 44 (5): 987-995, September – October, 2018

doi: 10.1590/S1677-5538.IBJU.2018.0194


ORIGINAL ARTICLE

Adem Altunkol 1, Deniz Abat 2, Nevzat Can Sener 1, Mehmet Gulum 3, Halil Ciftci 4, Murat Savas 5, Ercan Yeni 6
1 Department of Urology, Adana City Teaching and Research Hospital, University of Healthy Sciences, Adana, Turkey; 2 Department of Urology, Ministry of Health, Iskenderun State Hospital, Hatay, Turkey; 3 Department of Urology, Ankara Keçiören Teaching and Research Hospital, University of Healthy Sciences, Ankara, Turkey; 4 Department of Urology, Faculty of Medicine, Harran University, Şanliurfa, Turkey; 5 Department of Urology, Antalya Teaching and Research Hospital, University of Healthy Sciences, Antalya, Turkey; 6 Department of Urology, Ankara Numune Teaching and Research Hospital, University of Healthy Sciences, Ankara, Turkey

ABSTRACT

Objective: To compare standard urotherapy with a combination of urotherapy and biofeedback sessions and to determine the changes that these therapies promote in children with dysfunctional voiding.

Patients and Methods: The data of 45 patients who participated in the study from January 2010 to March 2013 were evaluated. All patients underwent urinary system ultrasonography to determine post-void residual urine volumes and urinary system anomalies. All patients were diagnosed using uroflowmetry – electromyography (EMG). The flow pattern, maximum flow rate, and urethral sphincter activity were evaluated in all patients using uroflowmetry – EMG. Each patient underwent standard urotherapy, and the results were recorded. Subsequently, biofeedback sessions were added for all patients, and the changes in the results were recorded and statistically compared.

Results: A total of forty – five patients were included, of which 34 were female and 11 were male and the average age of the patients was 8.4 ± 2.44 years (range: 5 – 15 years). After the standard urotherapy plus biofeedback sessions, the post-void residual urine volumes, incontinence rates and infection rates of patients were significantly lower than those with the standard urotherapy (p < 0.05). A statistically significant improvement in voiding symptoms was observed after the addition of biofeedback sessions to the standard urotherapy compared with the standard urotherapy alone (p < 0.05).

Conclusions: Our study showed that a combination of urotherapy and biofeedback was more effective in decreasing urinary incontinence rates, infection rates and post – void residual urine volumes in children with dysfunctional voiding than standard urotherapy alone, and it also showed that this combination therapy corrected voiding patterns significantly and objectively.

Keywords: Biofeedback, Psychology; Child; Urinary Tract Infections

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