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Biofeedback as a first-line treatment for overactive bladder syndrome refractory to standard urotherapy in children

      Summary

      Introduction

      Overactive bladder syndrome (OAB) and dysfunctional voiding (DV) are subgroups of lower urinary tract dysfunction (LUTD). Standard urotherapy is the first-line treatment option of OAB in children.

      Objectives

      The aim was to investigate the use of biofeedback as a first-line treatment option in OAB refractory to standard urotherapy, and determine the factors affecting efficacy.

      Study design

      Between 2005 and 2015, we retrospectively analyzed a total of 136 hospital records of children with OAB who had not previously used any anticholinergics and were refractory to standard urotherapy. Patients with urgency and/or urge incontinence and/or making holding maneuvers to suppress urgency were defined as having OAB symptoms, and resolution of these complaints was defined as successful biofeedback therapy.

      Results

      Seventy-three of 136 OAB patients' urgency recovered by biofeedback therapy with the success rate of 53% (p < 0.001). Sixty-two of 101 patients with holding maneuvers (success rate 61%) (p < 0.001), 70 of 101 patients with urgency incontinence (success rate 69%) (p < 0.001), 76 of 114 patients with daytime incontinence (success rate 66%) (p = 0.023), 87 of 97 patients with enuresis (success rate 89%) (p = 0.009), and 27 of 39 patients with dysuria (success rate 69%) (p = 0.007) recovered from their symptoms significantly. The mean lower urinary tract symptom score (LUTSS) was 16.38 and 8.18 before and after biofeedback therapies, respectively (p < 0.001) (Table). Patients without holding maneuvers (p = 0.045), daytime incontinence (p = 0.030), and enuresis (p = 0.045) had better recovery compared to the opposites.

      Discussion

      TableThe results of biofeedback for overactive bladder syndrome symptoms and other symptoms.
      Before biofeedback therapy (n) After biofeedback therapy (n) Success rate (%) p
      Urgency 136 63 53% <0.001
      Holding maneuvers 101 39 61% <0.001
      Urgency incontinence 101 31 69% <0.001
      Daytime incontinence 114 38 66% 0.023
      Enuresis 97 10 89% 0.009
      Dysuria 39 12 69% 0.007

      Keywords

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