The aim of the study was to analyze the effects of pelvic floor muscle exercises with biofeedback in children with different lower urinary tract symptoms.

A prospective study analyzing the effects of pelvic floor muscle exercises with biofeedback was conducted in pediatric patients with various lower urinary tract symptoms. Validated National Version of Dysfunctional Voiding Symptoms Score Questionnaires and voiding diaries were collected prior to the treatment, as well as pressure flow studies with EMG.  Our treatment protocol encompasses 10 consecutive daily sessions with urotherapist. After the completion of the treatment voiding diaries, questionnaires and pressure flow studies with EMG were repeated and data were analyzed.

Total of 74 children were referred by the Pediatric Urologist  for pelvic floor muscle training with biofeedback. Thirty-five patients were diagnosed with isolated detrusor sphincetr dyssinergia (DSS), sixteen had idiopathic detrusor overactivity (DO), five had giggle incontinence, 7 had hesitancy and 15 had both detrusor overactivity and detrusor sphicter dyssinergia. Total of 58 (78,4%) patients had their symptoms ameliorated. The analyzed data showed no measurable improvement in additional 4 (5,4%) patients, even though they reported a personal impression of an improvement. Twelve patients (16,2%) without the positive effect of the therapy were immature and/or non-cooperative.  Four patients with isolated detrusor sphincetr dyssinergia (11,4%) did not have any improvement, one patient (2,9%) had a personal impression of an improvement, and 31 patients (88,6%) were measurably improved. Out of 16 patients with  idiopathic detrusor overactivity, 3 (18,7%) showed no improvement, 1 patient (6,3%) had a personal impression of an improvement, and 12 patients (75%) had a measurable improvement. Out of 15 patients with detrusor overactivity and detrusor sphicter dyssinergia, 3 (20%) had no improvement, 1 patient (6.7%) had a personal impression of an improvement and 11 patients (73,3%) were measurably improved. When it comes to patients with hesitancy one patient (14.3%) had no improvement, and one patient had a personal impression of an improvement, while there was a measurable improvement in 5 patients (71,4%). One patient with giggle incontinence (20%) showed no improvement, while there was a significant improvement in 4 patients (80%).

Pelvic floor muscle exercises with the addition of biofeedback, have a goal to make children aware of their pelvic floor musculature and to teach them functional ways of using these muscles. Although the main indication for initiating this therapy is detrusor sphincter dyssinergia, the study showed an improvement of symptoms in patients with other lower urinary tract symptoms as well.

Pelvic flow exercises with biofeedback are a very useful tool in treatment of various  lower urinary tract symptoms in pediatric population.