Sugar E C, Firlit C F
J Urol. 1982 Dec;128(6):1253-8. doi: 10.1016/s0022-5347(17)53450-3.
A major cause of urinary incontinence and/or recurrent urinary infections in neurologically intact children is vesical voluntary sphincter/urogenital diaphragm dyssynergia and/or "strain" dyssynergia. These acquired or learned mechanisms are characterized by increased striated muscle tone during micturition, residual urine, daytime wetting and/or urinary infections. Generally, pharmacotherapy is prescribed and manipulated to achieve modification of these dysfunctions. Recently, urodynamic biofeedback has surfaced as a suitable therapeutic alternative. We selected 10 children, between 6 1/2 and 16 years old, for biofeedback therapy because of age, intelligence, commitment and conviction to improve. Following inpatient biofeedback 8 of the 10 children demonstrated complete abatement of signs and symptoms in long-term surveillance (6 to 19 months after biofeedback), while 2 moderately improved. Our experience with biofeedback therapy demonstrated that all patients convert to synergistic voiding within 48 hours of therapy. Urodynamic biofeedback appears to be an extremely useful tool in the armamentarium of the urologist treating neurologically normal children with voiding disorders. The possibility that this modality may be useful for adults is intriguing.
在神经功能正常的儿童中，尿失禁和/或反复尿路感染的一个主要原因是膀胱自主括约肌/泌尿生殖膈协同失调和/或“用力”协同失调。这些后天获得或习得的机制的特点是排尿时横纹肌张力增加、残余尿量、日间遗尿和/或尿路感染。一般来说，会开出处方并调整药物治疗以改善这些功能障碍。最近，尿动力学生物反馈已成为一种合适的治疗选择。我们选择了10名年龄在6.5岁至16岁之间的儿童进行生物反馈治疗，原因是他们的年龄、智力、改善的意愿和信念。在住院进行生物反馈治疗后，10名儿童中有8名在长期监测（生物反馈治疗后6至19个月）中症状和体征完全消失，而2名有中度改善。我们在生物反馈治疗方面的经验表明，所有患者在治疗后48小时内都能转为协同排尿。尿动力学生物反馈似乎是泌尿科医生治疗排尿障碍的神经功能正常儿童的武器库中一种极其有用的工具。这种方法可能对成年人有用的可能性很吸引人。
