Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia

Introduction Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spina bifida. It is associated with urinary...

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Main Authors: Mervat Sheta Elsawy, Haytham El Metwally Badawy, Mohamed Abdel Sattar Sharafeldeen, Waleed Dawood
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Alexandria Journal of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/20905068.2024.2397741
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author Mervat Sheta Elsawy
Haytham El Metwally Badawy
Mohamed Abdel Sattar Sharafeldeen
Waleed Dawood
author_facet Mervat Sheta Elsawy
Haytham El Metwally Badawy
Mohamed Abdel Sattar Sharafeldeen
Waleed Dawood
author_sort Mervat Sheta Elsawy
collection DOAJ
description Introduction Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spina bifida. It is associated with urinary incontinence (UI), nocturnal enuresis, urgency, intermittency, and recurrent urinary tract infections (UTIs).The Aim of this Study It aims to assess the efficacy of biofeedback (BF) for achieving perineal synergy and improving symptoms in thirty children with refractory DSD who failed to improve with medical treatment in the last 2 to 3 years.Material and Methods Thirty children (20 girls and 10 boys) aged 6–18 years (mean: 9.2 ± 2.2 yrs) with refractory DSD who failed to show improvement after 2–3 years of medical treatment with recurrent UTI and failure to emptying completely their bladder using urodynamic study. After patients understood the concept of BF pelvic floor training were regularly scheduled twice weekly for up to 3 months. Improvement was assessed using interview with parents after 3 months with measurement of manomeric pelvic floor muscles (PFMs) during straining and urodynamic study.Results Seven (23.3%) of the 30 children had daytime UI and 11 (36.7%) had nighttime incontinence. 4/30 (13.3%) children had increased urgency and 5 (16.7%) had straining intermittency and 3% (10%) had Dysuria. After 3 months of BF pelvic floor training 7/30 (23.3%) of children were fully responsive 100% decrease of symptoms, 14/30 (46%) responded more than 90% decrease of their symptoms, 7/30 (23.3%) of children responded partial decrease of symptoms and 2/30 (0 to 49%) decrease of symptoms to BF pelvic floor training.Conclusions BF pelvic floor training is an effective therapeutic option for children with refectory DSD. It improves symptoms of children with DSD with decreased UTIs through decreasing pressure of PFMs during urination.
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spelling doaj-art-3ebfb4db5de34c8aadec97db4570d1932024-11-22T08:38:07ZengTaylor & Francis GroupAlexandria Journal of Medicine2090-50682090-50762024-12-0160134334710.1080/20905068.2024.2397741Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergiaMervat Sheta Elsawy0Haytham El Metwally Badawy1Mohamed Abdel Sattar Sharafeldeen2Waleed Dawood3Physical Medicine and Rehabilitation, Faculty of Medicine, Alexandria University, Bab Sharqi, EgyptUrology Department, Faculty of Medicine, Alexandria University, Bab Sharqi, EgyptUrology Department, Faculty of Medicine, Alexandria University, Bab Sharqi, EgyptUrology Department, Faculty of Medicine, Alexandria University, Bab Sharqi, EgyptIntroduction Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spina bifida. It is associated with urinary incontinence (UI), nocturnal enuresis, urgency, intermittency, and recurrent urinary tract infections (UTIs).The Aim of this Study It aims to assess the efficacy of biofeedback (BF) for achieving perineal synergy and improving symptoms in thirty children with refractory DSD who failed to improve with medical treatment in the last 2 to 3 years.Material and Methods Thirty children (20 girls and 10 boys) aged 6–18 years (mean: 9.2 ± 2.2 yrs) with refractory DSD who failed to show improvement after 2–3 years of medical treatment with recurrent UTI and failure to emptying completely their bladder using urodynamic study. After patients understood the concept of BF pelvic floor training were regularly scheduled twice weekly for up to 3 months. Improvement was assessed using interview with parents after 3 months with measurement of manomeric pelvic floor muscles (PFMs) during straining and urodynamic study.Results Seven (23.3%) of the 30 children had daytime UI and 11 (36.7%) had nighttime incontinence. 4/30 (13.3%) children had increased urgency and 5 (16.7%) had straining intermittency and 3% (10%) had Dysuria. After 3 months of BF pelvic floor training 7/30 (23.3%) of children were fully responsive 100% decrease of symptoms, 14/30 (46%) responded more than 90% decrease of their symptoms, 7/30 (23.3%) of children responded partial decrease of symptoms and 2/30 (0 to 49%) decrease of symptoms to BF pelvic floor training.Conclusions BF pelvic floor training is an effective therapeutic option for children with refectory DSD. It improves symptoms of children with DSD with decreased UTIs through decreasing pressure of PFMs during urination.https://www.tandfonline.com/doi/10.1080/20905068.2024.2397741Biofeedbackpelvic floor rehabilitationurodynamic studysphincter dyssynergiaurinary incontinence
spellingShingle Mervat Sheta Elsawy
Haytham El Metwally Badawy
Mohamed Abdel Sattar Sharafeldeen
Waleed Dawood
Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
Alexandria Journal of Medicine
Biofeedback
pelvic floor rehabilitation
urodynamic study
sphincter dyssynergia
urinary incontinence
title Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
title_full Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
title_fullStr Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
title_full_unstemmed Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
title_short Effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
title_sort effect of biofeedback pelvic floor training on urodynamic study in children with detrusor sphincter dyssynergia
topic Biofeedback
pelvic floor rehabilitation
urodynamic study
sphincter dyssynergia
urinary incontinence
url https://www.tandfonline.com/doi/10.1080/20905068.2024.2397741
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