Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

409 / 492

08:40 - 08:50
ESPUN S2-3 (O)
A BIG BLADDER A BIG PROBLEM. RESULTS OF BIOFEEDBACK THERAPY.
Katarzyna KRZEMINSKA1, Michal MATERNIK2, Magdalena DROZYNSKA-DUKLAS2, Piotr CZARNIAK2, Agata LAKOMY2,
Andrzej GOLEBIEWSKI3 and Aleksandra ZUROWSKA2
1) Medical University of Gdansk, Department of Physical Therapy, Gdansk, POLAND - 2) Medical University of Gdansk,
Department Paediatric & Adolescent Nephrology & Hypertension, Gdansk, POLAND - 3) Medical University of Gdansk,
Department of Surgery and Urology for Children and Adolescents, Gdansk, POLAND
PURPOSE
Children with big bladders may develop dysfunctional voiding (DV)following a long standing compensatory increase in
sphincter activity. Patients with DV may not respond to standard urotherapy. This prospective study presents the
results of animated biofeedback training of a cohort of 9 children with EMG documented DV and a bladder capacity (BC)
>600ml.
MATERIAL AND METHODS
9 children, aged 8-17,with BC > 600ml and DV registered during an urodynamic assessment with incontinence
symptoms unresponsive to prior urotherapy were included in the study. The frequency of bladder dysfunction symptoms
were evaluated at baseline and following 2 months of treatment by bladder diary and questionnaire according to ICCS
definitions. Primary outcome was defined as the resolution of bladder symptoms after 2 months of therapy
and the resolution of sphincter contraction on electromyography tracing at the same time point.
RESULTS
The bladder capacity ranged from 600 to 1100ml. Prior to treatment residual urine was observed in 9/9,8/9 had
recurent UTI, 8/9 declared wetting during the day and 2/9 during the night. 3/9 had a history of VUR. All of the
children demonstrated DV; additionally 3/9 had signs of an underactive bladder. Following 8 weeks of training
8/8 reported improvement for daytime incontinence, 2/2 for nighttime incontinence, 7/9 had still residual urine -
was still present on EMG recordings in all subjects.
CONCLUSIONS
2 month animated biofeedback training is a highly effective treatment for clinical resolution of incontinence symptoms in
children with big bladders and dysfunctional voiding but is too short to reverse the long standing compensatory
increased sphincter activity during voiding.