Burak KÖPRÜ
(Koru Ankara Hastanesi, Üroloji Kliniği, Ankara, Türkiye)
Turgay EBİLOĞLU
(Gülhane Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara, Türkiye)
Giray ERGİN
(Koru Ankara Hastanesi, Üroloji Kliniği, Ankara, Türkiye)
ENGİN KAYA
(Gülhane Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara, Türkiye)
Yusuf KİBAR
(Koru Ankara Hastanesi, Üroloji Kliniği, Ankara, Türkiye)
Yıl: 2020Cilt: 7Sayı: 3ISSN: 2148-9580Sayfa Aralığı: 211 - 217İngilizce

40 0
Which One Is More Effective for Lower Urinary Tract Dysfunctions in Children? Pelvic Floor Contraction or Pelvic Floor Relaxation in Biofeedback Therapy
Objective: The objective of this study is to investigate the results of contraction- and relaxation-based biofeedback (BF) in children with lower urinary tract dysfunction (LUTD). Materials and Methods: Between 2007 and 2017, we randomly directed children with the diagnosis of LUTD and refractory to standard urotherapy modifications via BF by using two different animations: animation A with relaxation nature BF (RBF) and animation B with contraction nature BF (CBF). The categories of non-response, partial response, and full response were defined as a 0-49% decrease, 50-99% decrease, and 100% decrease in the LUTD Symptom score, respectively. Results of biofeedback using RBF or CBF were compared. Results: There were 100 and 70 children in the RBF and CBF groups, respectively. Patients with an abnormal voiding pattern (abnormalVP) and a positive electromyography (EMG) activity (positive EMG) had a better resolution with RBF (p=0.001), whereas patients with abnormalVP and a negative EMG activity (negative EMG) had a better resolution with CBF (p=0.039). Despite being statistically insignificant, patients with a normal voiding pattern (normalVP) and positive EMG had a better resolution with CBF (p=0.452), whereas patients with normalVP and negative EMG had a better resolution with RBF (p=0.083). Conclusion: The EMG activity identifies the BF nature in children with LUTD and abnormalVP. Importantly, positive EMG had better results with RBF, whereas negative EMG had better results with CBF.
DergiAraştırma MakalesiErişime Açık
  • 1. Cardozo L, Stanton SL, Hafner J, Allan V. Biofeedback in the treatment of detrusor instability. Br J Urol 1978;50:250-254.
  • 2. Maizels M, King LR, Firlit CF. Urodynamic biofeedback: a new approach to treat vesical sphincter dyssynergia. J Urol 1979;122:205-209.
  • 3. McKenna PH, Herndon CD, Connery S, Ferrer FA. Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games. J Urol 1999;162:1056-1062.
  • 4. Vesna ZD, Milica L, Stankovic I, Marina V, Andjelka S. The evaluation of combined standard urotherapy, abdominal and pelvic floor retraining in children with dysfunctional voiding. J Pediatr Urol 2011;7:336-341.
  • 5. Kibar Y, Piskin M, Irkilata HC, Aydur E, Gok F, Dayanc M. Management of abnormal postvoid residual urine in children with dysfunctional voiding. Urology 2010;75:1472-1475.
  • 6. McKenna PH. Current role of biofeedback for pediatric lower urinary tract symptoms. J Urol 2015;193:14-15.
  • 7. Khen-Dunlop N, Van Egroo A, Bouteiller C, Biserte J, Besson R. Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatr Urol 2006;2:424-429.
  • 8. Yagci S, Kibar Y, Akay O, Kilic S, Erdemir F, Gok F, Dayanc M. The effect of biofeedback treatment on voiding and urodynamic parameters in children with voiding dysfunction. J Urol 2005;174:1994-1997; discussion 1997- 1998.
  • 9. Kaye JD, Palmer LS. Animated biofeedback yields more rapid results than nonanimated biofeedback in the treatment of dysfunctional voiding in girls. J Urol 2008;180:300-305.
  • 10. Tugtepe H, Thomas DT, Ergun R, Abdullayev T, Kastarli C, Kaynak A, Dagli TE. Comparison of Biofeedback Therapy in Children With Treatment-refractory Dysfunctional Voiding and Overactive Bladder. Urology 2015;85:900-904.
  • 11. De Paepe H, Renson C, Hoebeke P, Raes A, Van Laecke E, Vande Walle J. The role of pelvic-floor therapy in the treatment of lower urinary tract dysfunctions in children. Scand J Urol Nephrol 2002;36:260-267.
  • 12. Austin PF, Bauer SB, Bower W, Chase J, Franco I, Hoebeke P, Rittig S, Vande Walle J, von Gontard A, Wright A, Yang SS, Nevéus T. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children’s Continence Society. J Urol 2014;191:1863-1865.e13.
  • 13. Kibar Y, Ors O, Demir E, Kalman S, Sakallioglu O, Dayanc M. Results of biofeedback treatment on reflux resolution rates in children with dysfunctional voiding and vesicoureteral reflux. Urology 2007;70:563-566.
  • 14. Van Hoecke E, Baeyens D, Vanden Bossche H, Hoebeke P, Vande Walle J. Early detection of psychological problems in a population of children with enuresis: construction and validation of the Short Screening Instrument for Psychological Problems in Enuresis. J Urol 2007;178:2611-2615.
  • 15. Nevéus T, von Gontard A, Hoebeke P, Hjälmås K, Bauer S, Bower W, Jørgensen TM, Rittig S, Walle JV, Yeung CK, Djurhuus JC. The standardization of terminology of lower urinary tract function in children and adolescents: report from the Standardisation Committee of the International Children’s Continence Society. J Urol 2006;176:314-324.
  • 16. Akbal C, Genc Y, Burgu B, Ozden E, Tekgul S. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol 2005;173:969-973.
  • 17. Glazier DB, Ankem MK, Ferlise V, Gazi M, Barone JG. Utility of biofeedback for the daytime syndrome of urinary frequency and urgency of childhood. Urology 2001;57:791-793.
  • 18. Yamanishi T, Yasuda K, Murayama N, Sakakibara R, Uchiyama T, Ito H. Biofeedback training for detrusor overactivity in children. J Urol 2000;164:1686-1690.
  • 19. Meijer EF, Nieuwhof-Leppink AJ, Dekker-Vasse E, de Joode-Smink GC, de Jong TP. Central inhibition of refractory overactive bladder complaints, results of an inpatient training program. J Pediatr Urol 2015;11:21.e1-5.
  • 20. Porena M, Costantini E, Rociola W, Mearini E. Biofeedback successfully cures detrusor-sphincter dyssynergia in pediatric patients. J Urol 2000;163:1927- 1931.
  • 21. Sugar EC, Firlit CF. Urodynamic biofeedback: a new therapeutic approach for childhood incontinence/infection (vesical voluntary sphincter dyssynergia). J Urol 1982;128:1253-1258.
  • 22. Ebiloglu T, Ergin G, Irkilata HC, Kibar Y. The biofeedback treatment for nonmonosymptomatic enuresis nocturna. Neurourol Urodyn 2016;35:58-61.

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