Urotherapy and Biofeedback Treatment of Voiding Dysfunction in Children: Review

Lower urinary tract dysfunction (LUTD) contains a large spectrum of diseases that include overactive bladder, giggle incontinence, voiding retardation and Hinnman syndrome. LUTD, that decelops in children essentially can be categorized as the filling phase disorder and the voiding phase disorder. Incontinence is considered normal in children younger than five years however, when incontinence is observed at an age in which the child should control miction, it is considered abnormal. The term of dysfunctional voiding is describes the micturition phase abnormalities due to wrong acquired voiding habits in children without any neurological disorders. It appears due to the overactivity or insufficient relaxation of pelvic floor muscles during voiding. Clinical presentation of voiding dysfunction includes enuresis, diurnal incontinence, dysuria, pollacuria, urgency, and recurrent urinary tract infections (UTI) with vesicoureteral reflux (VUR). Biofeedback therapy of the pelvic floor muscles is very effective and successful in the treatment of voiding dysfunctions. Biofeedback treatment provides significant improvements in disorders such as urinary system infection, VUR, and spinning top urethra (STU), secondary to dysfunctional voiding. The goal of the biofeedback therapy is to use the pelvic floor muscles which have an important role in the micturation control more effectively. Children should be aware of their pelvic floor muscles and their functions before beginning of the biofeedback treatment. Children who are candidates for biofeedback treatment should cooperative well and they must not have any motivation problems; thus, they should be over 5 years of age. The most important factor is the mental maturity.