Ebiloglu Turgay, Kaya Engin, Köprü Burak, Topuz Bahadır, Irkilata Hasan Cem, Kibar Yusuf
Etimesgut Military Hospital, Department of Urology, Ankara, Turkey.
Gulhane Military Medical Academy, Department of Urology, Ankara, Turkey.
J Pediatr Urol. 2016 Oct;12(5):290.e1-290.e7. doi: 10.1016/j.jpurol.2016.02.018. Epub 2016 Mar 31.
Overactive bladder syndrome (OAB) and dysfunctional voiding (DV) are subgroups of lower urinary tract dysfunction (LUTD). Standard urotherapy is the first-line treatment option of OAB in children.
The aim was to investigate the use of biofeedback as a first-line treatment option in OAB refractory to standard urotherapy, and determine the factors affecting efficacy.
Between 2005 and 2015, we retrospectively analyzed a total of 136 hospital records of children with OAB who had not previously used any anticholinergics and were refractory to standard urotherapy. Patients with urgency and/or urge incontinence and/or making holding maneuvers to suppress urgency were defined as having OAB symptoms, and resolution of these complaints was defined as successful biofeedback therapy.
Seventy-three of 136 OAB patients' urgency recovered by biofeedback therapy with the success rate of 53% (p < 0.001). Sixty-two of 101 patients with holding maneuvers (success rate 61%) (p < 0.001), 70 of 101 patients with urgency incontinence (success rate 69%) (p < 0.001), 76 of 114 patients with daytime incontinence (success rate 66%) (p = 0.023), 87 of 97 patients with enuresis (success rate 89%) (p = 0.009), and 27 of 39 patients with dysuria (success rate 69%) (p = 0.007) recovered from their symptoms significantly. The mean lower urinary tract symptom score (LUTSS) was 16.38 and 8.18 before and after biofeedback therapies, respectively (p < 0.001) (Table). Patients without holding maneuvers (p = 0.045), daytime incontinence (p = 0.030), and enuresis (p = 0.045) had better recovery compared to the opposites.
Biofeedback can be thought of as the first-line treatment option when standard urotherapy fails in children with OAB.
膀胱过度活动症（OAB）和排尿功能障碍（DV）是下尿路功能障碍（LUTD）的亚组。标准尿疗法是儿童OAB的一线治疗选择。
旨在研究生物反馈作为标准尿疗法难治性OAB的一线治疗选择的应用，并确定影响疗效的因素。
2005年至2015年期间，我们回顾性分析了136例OAB患儿的医院记录，这些患儿此前未使用过任何抗胆碱能药物且对标准尿疗法难治。有尿急和/或急迫性尿失禁和/或采取憋尿动作以抑制尿急的患者被定义为有OAB症状，这些症状的缓解被定义为生物反馈治疗成功。
136例OAB患者中有73例通过生物反馈治疗尿急症状得到缓解，成功率为53%（p<0.001）。101例有憋尿动作的患者中有62例（成功率61%）（p<0.001），101例有急迫性尿失禁的患者中有70例（成功率69%）（p<0.001），114例有日间尿失禁的患者中有76例（成功率66%）（p = 0.023），97例有遗尿症的患者中有87例（成功率89%）（p = 0.009），39例有排尿困难的患者中有27例（成功率69%）（p = 0.007）症状明显缓解。生物反馈治疗前后平均下尿路症状评分（LUTSS）分别为16.38和8.18（p<0.001）（表）。与有憋尿动作、日间尿失禁和遗尿症的患者相比，没有这些症状的患者恢复情况更好（p = 0.045、p = 0.030和p = 0.045）。
当标准尿疗法对患有OAB的儿童无效时，生物反馈可被视为一线治疗选择。
