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THE EFFICACY OF BIOFEEDBACK THERAPY ON HYDRONEPHROSIS SECONDARY
TO DYSFUNCTIONAL VOIDING IN CHILDREN
Seyedeh-Sanam LADI-SEYEDIAN, Abdol-Mohammad KAJBAFZADEH, Lida SHARIFI-RAD and Erfan AMINI
Tehran University of Medical Science, Pediatric Center of Excellence, Section of Tissue Engineering and Stem Cell
Therapy, Tehran, IRAN (ISLAMIC REPUBLIC OF)
PURPOSE
The aim of this study is to assess the potential efficacy of biofeedback therapy and home pelvic floor exercises in
children with dysfunctional voiding (DV) associated with mild to moderate hydronephrosis.
MATERIAL AND METHODS
This prospective study comprised fifty seven children (35 boys, 22 girls; mean age 8.9±2.6) with mild to moderate
hydronephrosis secondary to DV. All children were regularly visited at our pediatric urology clinic. DTPA, US and
uroflowmetry/EMG were performed in all study participants at baseline. Children with evidence of complete obstruction
in DTPA scan were excluded from enrollment. Children were randomly allocated into two groups including control group
who underwent standard urotherapy (diet, hydration, scheduled voiding) and case group who received biofeedback
therapy in addition to standard urotherapy. A complete 3-day voiding diary was recorded by parents before and after
treatment. Re-evaluation with kidney and bladder ultrasound and uroflowmetry/EMG was also performed 6 months and
one year after completion of treatment.
RESULTS
We noted a more significant decline in APD diameter in case group compared to control group (P<0.05, Table 1). The
mean maximal flow rate prior to treatment was 22.8±6 and 23±7ml/sec in case and control groups, respectively. This
finding decreased significantly one year after the treatment in case group compared to controls (32±7.9 ml/sec vs.
24±12 ml/sec, respectively; P<0.04). Improvement of various parameters in voiding diary was also more significant in
the case group. Right and left APD prior and after biofeedback are as follow:
Right APD Left APD Right APD Left APD
before treatment at follow-up
Case 14.9±6 17.6±6.8 7.1±4.3 8.1±5
Control 13.8±5.2 14.4±4.9 12±3.3 13±4
CONCLUSIONS
Biofeedback therapy should be considered as a potential effective modality in treating hydronephrosis secondary to DV
in children.