Urodynamic biofeedback training for children with bladder-sphincter dyscoordination during voiding

Neurologically normal children with recurrent urinary tract infections (UTIs), night‐ and daytime wetting, and urge and painful voiding may have staccato voiding due to pelvic floor contractions. The immediate effect of non‐invasive urodynamic biofeedback (BF) therapy was assessed using a historical follow‐up study in 31 children aged 5–15 years suffering from urodynamically proven overactive urethra during voiding. A long‐term follow‐up study was performed to investigate whether improvement was maintained. Twenty‐four children (77.5%) benefited from the treatment. Of these 16 (51.5%) were cured, while 8 (26%) had a pronounced reduction in their symptoms. Although the flow was normalized in 17 (55%) and nearly normalized in 7 (22.5%), there was no significant correlation between subjective and objective criteria of improvement. Similarly, no relationship was found between the initial urodynamic characteristics and the treatment outcome. During a mean follow‐up time of 4 years (range: 1–7.5 years) two of the initially cured patients relapsed. They were recured with a refresher course. Three had had a single or a few episodes of cystitis in the course of several years. Of the patients with pronounced reduction in their symptoms, three relapsed. A refresher course was attempted in two patients; one was successful. It can thus be concluded that BF is an effective way of treating this disturbance and the beneficial effect is to a wide degree maintained.