Mir Sohail Fazeli1, Yiqun Lin2, Nooshin Nikoo2, Sravan Jaggumantri1, Jean-Paul Collet1, Kourosh Afshar3. 1. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. 2. School of Public and Population Health, University of British Columbia, Vancouver, British Columbia, Canada. 3. Department of Urology, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: kafshar@cw.bc.ca.
Abstract
PURPOSE: Biofeedback has been used to treat children with symptoms of bladder dysfunction not responding to standard therapy alone. However, evidence of the effectiveness of biofeedback is scarce and is based on small studies. We conducted a systematic review of the literature to assess the effects of biofeedback as adjunctive therapy for symptoms of nonneuropathic voiding disorders in children up to age 18 years. MATERIALS AND METHODS: We searched MEDLINE(®), Embase(®) and CENTRAL on the OvidSP(®) platform as well as conference proceedings for randomized trials presented at scientific conventions, symposia and workshops through August 13, 2013. Hand searches and review of reference lists of retrieved articles were also performed. RESULTS: Five eligible studies were included in the systematic review, of which 4 (382 participants) were pooled in the meta-analysis based on available outcomes data. The overall proportion of cases with resolved incontinence at month 6 was similar in the biofeedback and control groups (OR 1.37 [95% CI 0.64 to 2.93], RD 0.07 [-0.09, 0.23]). There was also no significant difference in mean maximum urinary flow rate (mean difference 0.50 ml, range -0.56 to 1.55) or likelihood of urinary tract infection (OR 1.30 [95% CI 0.65 to 2.58]). CONCLUSIONS: Current evidence does not support the effectiveness of biofeedback in the management of children with nonneuropathic voiding disorders. More high quality, randomized controlled trials are needed to better evaluate the effect of biofeedback.
PURPOSE: Biofeedback has been used to treat children with symptoms of bladder dysfunction not responding to standard therapy alone. However, evidence of the effectiveness of biofeedback is scarce and is based on small studies. We conducted a systematic review of the literature to assess the effects of biofeedback as adjunctive therapy for symptoms of nonneuropathic voiding disorders in children up to age 18 years. MATERIALS AND METHODS: We searched MEDLINE(®), Embase(®) and CENTRAL on the OvidSP(®) platform as well as conference proceedings for randomized trials presented at scientific conventions, symposia and workshops through August 13, 2013. Hand searches and review of reference lists of retrieved articles were also performed. RESULTS: Five eligible studies were included in the systematic review, of which 4 (382 participants) were pooled in the meta-analysis based on available outcomes data. The overall proportion of cases with resolved incontinence at month 6 was similar in the biofeedback and control groups (OR 1.37 [95% CI 0.64 to 2.93], RD 0.07 [-0.09, 0.23]). There was also no significant difference in mean maximum urinary flow rate (mean difference 0.50 ml, range -0.56 to 1.55) or likelihood of urinary tract infection (OR 1.30 [95% CI 0.65 to 2.58]). CONCLUSIONS: Current evidence does not support the effectiveness of biofeedback in the management of children with nonneuropathic voiding disorders. More high quality, randomized controlled trials are needed to better evaluate the effect of biofeedback.
Authors: Stephen Yang; Michael E Chua; Stuart Bauer; Anne Wright; Per Brandström; Piet Hoebeke; Søren Rittig; Mario De Gennaro; Elizabeth Jackson; Eliane Fonseca; Anka Nieuwhof-Leppink; Paul Austin Journal: Pediatr Nephrol Date: 2017-10-03 Impact factor: 3.714