URODYNAMIC BIOFEEDBACK TRAINING FOR CHILDREN WITH BLADDER-SPHINCTER DYSCOORDINATION DURING VOIDING

Neurologically normal children with recurrent urinary tract infections (UTIs), night- and daytime wetting, and urge and painful voiding may have staccato voiding due to pelvic floor contractions. The immediate effect of non-invasive urodynamic biofeedback (BF) therapy was assesse d using a historical follow-up study in 31 children aged 5-15 years su ffering from urodynamically proven overactive urethra during voiding. A long-term follow-up study was performed to investigate whether impro vement was maintained. Twenty-four children (77.5%) benefited from the treatment. Of these 16 (51.5%) were cured, while 8 (26%) had a pronou nced reduction in their symptoms. Although the flow was normalized in 17 (55%) and nearly normalized in 7 (22.5%), there was no significant correlation between subjective and objective criteria of improvement. Similarly, no relationship was found between the initial urodynamic ch aracteristics and the treatment outcome. During a mean follow-up time of 4 years (range: 1-7.5 years) two of the initially cured patients re lapsed. They were recured with a refresher course. Three had had a sin gle or a few episodes of cystitis in the course of several years. Of t he patients with pronounced reduction in their symptoms, three relapse d. A refresher course was attempted in two patients; one was successfu l. It can thus be concluded that BF is an effective way of treating th is disturbance and the beneficial effect is to a wide degree maintaine d.