Seyedeh Sanam Ladi Seyedian1, Lida Sharifi-Rad, Maryam Ebadi, Abdol-Mohammad Kajbafzadeh. 1. Pediatric Urology Research Center and Department of Pediatric Urology, Children's Hospital Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Qarib's St, Keshavarz Blvd, Tehran, 14194 33151, Iran.
Abstract
UNLABELLED: We report the clinical results of two types of urotherapy programs in children with dysfunctional voiding (DV). Sixty children with a median age of 8 (range, 5-14) diagnosed with DV were randomly allocated to one of two groups, each made up of 30 patients. Patients in group A underwent behavioral urotherapy (hydration, scheduled voiding, toilet training, and high-fiber diet) combined with pelvic floor muscle (PFM) exercises, whereas group B only received behavioral urotherapy. All parents completed a voiding and bowel habit diary chart. Uroflowmetry with pelvic floor surface electromyography (EMG) and bladder ultrasound were performed on all patients at the beginning and the end of the 1-year study. Abnormal voiding pattern normalized to a bell shape in 21/30 of patients in group A and 8/30 of patients in group B (P < 0.000). EMG activity during voiding disappeared significantly in 23/30 patients in group A compared to 15/30 patients in group B (P < 0.02). Episodes of urgency resolved in 12/14 of patients in group A and 3/11 of patients in group B (P < 0.01). Daytime wetting improved in 15/17 and 4/11 of patients in groups A and B, respectively. In addition, reduction in post-void residue (PVR) was significant in group A (P < 0.003). CONCLUSION:Functional PFM exercises with Swiss ball combined with behavioral urotherapy proved as a safe and effective therapeutic modality, reducing the frequency of urinary incontinence, PVR, and the severity of constipation in children with DV.
RCT Entities:
UNLABELLED: We report the clinical results of two types of urotherapy programs in children with dysfunctional voiding (DV). Sixty children with a median age of 8 (range, 5-14) diagnosed with DV were randomly allocated to one of two groups, each made up of 30 patients. Patients in group A underwent behavioral urotherapy (hydration, scheduled voiding, toilet training, and high-fiber diet) combined with pelvic floor muscle (PFM) exercises, whereas group B only received behavioral urotherapy. All parents completed a voiding and bowel habit diary chart. Uroflowmetry with pelvic floor surface electromyography (EMG) and bladder ultrasound were performed on all patients at the beginning and the end of the 1-year study. Abnormal voiding pattern normalized to a bell shape in 21/30 of patients in group A and 8/30 of patients in group B (P < 0.000). EMG activity during voiding disappeared significantly in 23/30 patients in group A compared to 15/30 patients in group B (P < 0.02). Episodes of urgency resolved in 12/14 of patients in group A and 3/11 of patients in group B (P < 0.01). Daytime wetting improved in 15/17 and 4/11 of patients in groups A and B, respectively. In addition, reduction in post-void residue (PVR) was significant in group A (P < 0.003). CONCLUSION: Functional PFM exercises with Swiss ball combined with behavioral urotherapy proved as a safe and effective therapeutic modality, reducing the frequency of urinary incontinence, PVR, and the severity of constipation in children with DV.
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