Home uroflowmetry biofeedback in behavioral training for dysfunctional voiding in school-age children: a randomized controlled study.

Full Abstract

PURPOSE:
We studied the added value of home uroflowmetry for biofeedback training compared to added attention and standard therapy in a multicomponent behavioral training program for voiding disorders in school-age children. Little is known about the role of biofeedback by home uroflowmetry for dysfunctional voiding due to NNBSD in children.

MATERIALS AND METHODS:
A randomized controlled study was conducted at an outpatient pediatric incontinence university clinic from January 2000 to June 2003. A total of 192 children 6 to 16 years old who were suffering from recurrent urinary tract infections with or without urge incontinence were screened for NNBSD. Of 143 eligible patients 44 were randomly allocated to receive 8 weeks of standard therapy (outpatient behavioral therapy), 46 to receive 8 weeks of home video instructions together with standard therapy and 53 to receive 8 weeks of home uroflowmetry biofeedback together with standard therapy. After 8 weeks all treatment groups proceeded with standard therapy for 16 weeks, after which prophylaxis with antibiotics was stopped and patients were followed for another 6 months. Main outcome measurement was total relief of complaints, namely urinary tract infections and, if present, incontinence, at 12 months after randomization.

RESULTS:
At baseline there was no reason to predict major incomparabilities between the groups. In an intent to treat analysis there was no difference in total relief between standard treatment (44%) and added video instruction (42%, RR 0.96, 95% CI 0.59 to 1.56). Total relief in the added home uroflowmetry group (55%) was higher than with standard therapy (RR 1.24, 95% CI 0.80 to 1.93), although the difference was not statistically significant. A per protocol analysis suggested that the groups with added home uroflowmetry showed better total relief than the pooled groups with standard therapy and those with added video (RR 1.40, 95% CI 0.98 to 2.00).

CONCLUSIONS:
Home uroflowmetry appears to be a useful adjunctive treatment for the reduction of complaints in children with dysfunctional voiding due to nonneurogenic bladder-sphincter dyssynergia.

Learn Faster Today Improve your study skills

Author information

Author/s: Klijn, Aart J (AJ); Uiterwaal, Cuno S P M (CS); Vijverberg, Marianne A W (MA); Winkler, Pauline L H (PL); Dik, Pieter (P); de Jong, Tom P V M (TP);

Affiliation: Department of Pediatric Urology, University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. a.j.klijn(-atsign-)umcutrecht.nl

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial

Journal: The Journal of urology (J Urol), published in United States. (Language: eng)

Reference: 2006-Jun; vol 175 (issue 6) : pp 2263-8; discussion 2268

Dates: Created 2006/05/15; Completed 2006/07/25; Revised 2007/03/19;

PMID: 16697850, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Nat Clin Pract Urol. 2007 Jan;4(1):14-5. (PMID: 17211417)

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Behavior Therapy
Biofeedback (Psychology) - instrumentation
Child
Equipment Design
Female

These are the highest related articles currently in the database:

See 100+ related articles.