Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: systematic review

被引:39
作者
Desantis, Darren J.
Leonard, Michael P.
Preston, Mark A.
Barrowman, Nicholas J. [3 ]
Guerra, Luis A. [1 ,2 ]
机构
[1] Univ Ottawa, Childrens Hosp Eastern Ontario, Dept Urol, Div Pediat Urol, Ottawa, ON K1H 8L1, Canada
[2] Univ Ottawa, Dept Epidemiol & Community Med, Ottawa, ON K1H 8L1, Canada
[3] Univ Ottawa, CHEO Res Inst, Ottawa, ON K1H 8L1, Canada
关键词
Biofeedback; Dysfunctional voiding; Dysfunction elimination syndrome; UTI; Urinary incontinence; Constipation; Children; DETRUSOR-SPHINCTER DYSSYNERGIA; INTERACTIVE COMPUTER GAMES; PELVIC-FLOOR EXERCISES; VOIDING DYSFUNCTION; URODYNAMIC BIOFEEDBACK; VESICOURETERAL REFLUX; CHILDREN; THERAPY; PROGRAM; INCONTINENCE;
D O I
10.1016/j.jpurol.2011.02.019
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: Dysfunctional elimination syndrome is associated with an inability to effectively empty the bladder and may present with UTI, incontinence, intestinal constipation or other voiding symptoms. Biofeedback has emerged as one potentially effective and non-invasive treatment. We sought to analyze if biofeedback is an effective method to treat children less than 18 years of age. Methods: A literature search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Database, AUA, CUA, AAP and ESPU abstracts. Copies of all relevant articles were retrieved for quality assessment and data abstraction by two independent reviewers. Primary outcomes were UTIs and daytime incontinence. Results: 27 studies were included (1 RCT and 26 case-series). The pooled estimate showed 83% (95% CI: 79% 86%) and 80% (95% CI: 76%-85%) improvement in UTI and daytime incontinence respectively. I-2 statistic showed "Low" (7%) and "High" (77%) heterogeneity across studies results for UTI and daytime incontinence. The only included RCT favored biofeedback over standard therapy (RR 1.4, 95% CI: 0.98-2.00) but this was not statistically significant. On analysis of all included studies there was also improvement in constipation (18%-100%), frequency (67%-100%), urgency (71%-88%) and VUR (21%-100%). PVR improvement ranged from 26 ml to 99 ml and Q(max) improvement was from 3.1 ml/s-4.7 ml/s. Conclusion: Based on this review, biofeedback is an effective, non-invasive method of treating dysfunctional elimination syndrome, and approximately 80% of children benefited from this treatment. However, most reports were of low level of evidence and studies of more solid design such as RCT should be conducted. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:342 / 348
页数:7
相关论文
共 30 条
[1]   Nonpharmacological treatment of lower urinary tract dysfunction using biofeedback and transcutaneous electrical stimulation:: a pilot study [J].
Barroso, Ubirajara, Jr. ;
Lordelo, Patricia ;
Lopes, Antonio A. ;
Andrade, Juarez ;
Macedo, Antonio, Jr. ;
Ortiz, Valdemar .
BJU INTERNATIONAL, 2006, 98 (01) :166-171
[2]   A modified biofeedback program for children with detrusor-sphincter dyssynergia: 5-year experience [J].
Chin-Peuckert, L ;
Salle, JLP .
JOURNAL OF UROLOGY, 2001, 166 (04) :1470-1475
[3]   Biofeedback therapy for children with dysfunctional voiding [J].
Combs, AJ ;
Glassberg, AD ;
Gerdes, D ;
Horowitz, M .
UROLOGY, 1998, 52 (02) :312-315
[4]   Biofeedback therapy and dysfunctional voiding in children [J].
Barry P. Duel .
Current Urology Reports, 2003, 4 (2) :142-145
[5]   Therapy concept in enuretic children [J].
Etele-Hainz, A ;
Artens, E ;
Marberger, M .
EUROPEAN UROLOGY, 1998, 33 :49-52
[6]   Utility of biofeedback for the daytime syndrome of urinary frequency and urgency of childhood [J].
Glazier, DB ;
Ankem, MK ;
Ferlise, V ;
Gazi, M ;
Barone, JG .
UROLOGY, 2001, 57 (04) :791-793
[7]   Changing concepts concerning the management of vesicoureteral reflux [J].
Herndon, CDA ;
DeCambre, M ;
McKenna, PH .
JOURNAL OF UROLOGY, 2001, 166 (04) :1439-1443
[8]   Interactive computer games for treatment of pelvic floor dysfunction [J].
Herndon, CDA ;
Decambre, M ;
McKenna, PH .
JOURNAL OF UROLOGY, 2001, 166 (05) :1893-1898
[9]   VESICAL AND URETERAL DAMAGE FROM VOIDING DYSFUNCTION IN BOYS WITHOUT NEUROLOGIC OR OBSTRUCTIVE DISEASE [J].
HINMAN, F ;
BAUMANN, FW .
JOURNAL OF UROLOGY, 1973, 109 (04) :727-732
[10]  
Khen-Dunlop Naziha, 2006, J Pediatr Urol, V2, P424, DOI 10.1016/j.jpurol.2005.09.004