Biofeedback successfully cures detrusor-sphincter dyssynergia in pediatricpatients

Purpose: We assessed the efficacy of voiding and bladder biofeedback for ac hieving perineal synergy and curing symptoms in children with detrusor-sphi ncter dyssynergia Materials and Methods: A total of 16 boys and 27 girls 4 to 14 years old wi th detrusor-sphincter dyssynergia diagnosed by uroflowmetry and electromyog raphy underwent biweekly voiding biofeedback therapy consisting of perineal floor electromyography during uroflowmetry. The 6 patients with enuresis a nd an unstable bladder also underwent bladder biofeedback training during c ystometry. Biofeedback continued until detrusor-sphincter dyssynergia resol ved. Followup consisted of electromyography and uroflowmetry 1 month after completing biofeedback training, and telephone interviews after 2 and 4 yea rs. Results: Biofeedback resolved detrusor-sphincter dyssynergia in all childre n, although the condition disappeared significantly sooner in girls (p < 0. 02). Secondary enuresis disappeared significantly earlier than primary enur esis (p < 0.0001). The 2-year success rate of 87.18% for enuresis decreased to 80% at the 4-year followup. Conclusions: Voiding and bladder biofeedback achieves perineal synergy and cures symptoms in children with detrusor-sphincter dyssynergia.