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Alt Üriner Sistem Disfonksiyonu Olan Çocuklarda Biyofeedback Tedavisinin Etkinliği

Yıl 2022, Cilt: 16 Sayı: 2, 117 - 120, 16.03.2022
https://doi.org/10.12956/tchd.858689

Öz

Amaç: Alt üriner sistem disfonksiyonu geniş spektrumlu bir tanıdır ve Uluslarararası Çocuk İşeme Topluluğuna göre aşırı aktif mesane, işemeyi erteleme, az aktif mesane, seyrek işeme, vajinal reflü, mesane boynu disfonksiyonu ve kıkırdama inkontinansını içerir.
Biyofeedback kolay uygulanabilen, girişimsel olmayan ve normal mesane ve barsak fonksiyonlarının sağlanmasında pelvik duvar kaslarını aktive etmek için kullanılan bir tedavi yöntemidir. Bu çalışmada alt üriner sistem disfonksiyonu olan çocuklarda biyofeedback tedavisinin etkinliğinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Çalışmaya alt üriner sistem disfonksiyonu tanısı alan ve standart tedaviye yanıt vermeyen 29 hasta dahil edildi. Bu hastalara 8 hafta süre ile biyofeedback tedavisi uygulandı.

Bulgular: Animasyon biofeedback tedavisinden sonra 13 hastada (%44.8) gündüz, iki (%6.8) hastada gece kaçırma şikayetleri düzeldi. Kabızlığı olan 5 hastada tamamen düzelme olmasına rağmen enkoprezisi olan hastalarda düzelme olmadı. Altı hastanın (% 20.7) şikayetlerinde azalma oldu ancak tam düzelme olmadı. Biofeedback tedavisi öncesi 16.19±7.69 olan ortalama işeme bozuklukları semptom skoru, tedavi sonrası 9.52±6.4’e geriledi ve istatistiksel olarak anlamlı bir fark (p<0.001£) saptandı.

Sonuç: Çalışmamızdan elde ettiğimiz sonuçlara ve literatür taramalarına göre standart tedaviden fayda görmeyen alt üriner sistem disfonksiyonu olan çocuklarda biyofeedback tedavisi faydalı olabilir.

Kaynakça

  • 1. Nevéus T, Gontard A, Hoebeke P et al. The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Report from the Standardization Committee of the International Children’s Continence Society. J Urol. 2006;176, 314-324.
  • 2. Austin PF, Bauer SB, Bower W et al. T. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. J Urol. 2014;191:1863-1865.
  • 3. Tremback-Ball A, Gherghel E, Hegge A, Kindig K, Marsico H, Scanlon R. The effectiveness of biofeedback therapy in managing Bladder Bowel Dysfunction in children: A systematic review. J Pediatr Rehabil Med. 2018;11:161-173.
  • 4. Koenig JF, McKenna PH. Biofeedback therapy for dysfunctional voiding in children. Curr Urol Rep. 2011; 12, 382 144.
  • 5. Desantis DJ, Leonard MP, Preston MA, Barrowman NJ, Guerra LA. Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: A systematic review. J Pediatric Urol. 2011; 7: 342-348.
  • 6. Fazeli MS, Lin Y, Nikoo N, Jaggumantri S, Collet J-P, Afshar K. Biofeedback for nonneuropathic daytime voiding disorders in children: A systematic review and meta-analysis of randomized controlled trials. J Urol. 2015; 193: 274-280.
  • 7. Akbal C, Genc Y, Burgu B, Özden E, Tekgül S. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005; 173:969-73.
  • 8. McKenna PH. Current role of biofeedback for pediatric lower urinary tract symptoms. J Urol 2015; 193:14-5.
  • 9. Tugtepe H, Thomas DT, Ergun R et al. Comparison of biofeedback therapy in children with treatment-refractory dysfunctional voiding and overactive bladder. Urology. 2015; 85: 900-904.
  • 10. Khen-Dunlop N, Van Egroo A, Bouteiller C, Biserte J, Besson R. Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatric Urol. 2006; 2: 424-29.
  • 11. Zeng F, Chen HQ, Qi L, Zhang XY, Li Y. Comparative study of pelvic floor biofeedback training and tolterodine for treatment of detrusor after-contraction in posturination dribbling in children. J Int Med Res. 444 2012; 40: 2305-10.
  • 12. Ladi-Seyedran S, Kajbafzadeh AM, Sharifi-Rad L, Shadgan B, Fan E. Management of non-neuropathic underactive bladder in children with dysfunctional voiding by animated biofeedback: A randomized clinical trial. Urology. 2015;85: 205-210.

The Role of Biofeedback Treatment in Children with Lower Urinary Tract Dysfunction

Yıl 2022, Cilt: 16 Sayı: 2, 117 - 120, 16.03.2022
https://doi.org/10.12956/tchd.858689

Öz

Objective: Lower urinary tract dysfunction is a wide clinical spectrum and according to the International Children’s Continence Society, lower urinary tract dysfunction contains overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence.
Biofeedback is a non-invasive therapy that can be applied easily and aims to activate relevant pelvic wall muscles for normal bowel and bladder functions. This study aimed to evaluate the efficacy of biofeedback treatment in children with lower urinary tract dysfunction.

Material and Methods: Twenty-nine patients who were diagnosed with lower urinary tract dysfunction and did not respond to standard therapy were included in the study. Biofeedback therapy was applied to these patients for 8 weeks.


Results:
After animation biofeedback treatment, daytime symptoms improved in 13 patients (44.8%), and nighttime enuresis improved in two (6.8%) patients. Although 5 patients with constipation completely improved, there was no improvement in patients with encopresis. There was a decrease but not a complete improvement in complaints of six patients (20.7%). Mean urinary incontinence symptom score which was 16.19±7.69 before biofeedback treatment decreased to 9.52±6.4 after the treatment, with a statistically significant difference (p<0.001).

Conclusion: It was suggested that biofeedback treatment can be considered as a suitable alternative in children with dysfunctional urination who do not respond to standard treatment.

Kaynakça

  • 1. Nevéus T, Gontard A, Hoebeke P et al. The Standardization of Terminology of Lower Urinary Tract Function in Children and Adolescents: Report from the Standardization Committee of the International Children’s Continence Society. J Urol. 2006;176, 314-324.
  • 2. Austin PF, Bauer SB, Bower W et al. T. The standardization of terminology of lower urinary tract function in children and adolescents: update report from the Standardization Committee of the International Children's Continence Society. J Urol. 2014;191:1863-1865.
  • 3. Tremback-Ball A, Gherghel E, Hegge A, Kindig K, Marsico H, Scanlon R. The effectiveness of biofeedback therapy in managing Bladder Bowel Dysfunction in children: A systematic review. J Pediatr Rehabil Med. 2018;11:161-173.
  • 4. Koenig JF, McKenna PH. Biofeedback therapy for dysfunctional voiding in children. Curr Urol Rep. 2011; 12, 382 144.
  • 5. Desantis DJ, Leonard MP, Preston MA, Barrowman NJ, Guerra LA. Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: A systematic review. J Pediatric Urol. 2011; 7: 342-348.
  • 6. Fazeli MS, Lin Y, Nikoo N, Jaggumantri S, Collet J-P, Afshar K. Biofeedback for nonneuropathic daytime voiding disorders in children: A systematic review and meta-analysis of randomized controlled trials. J Urol. 2015; 193: 274-280.
  • 7. Akbal C, Genc Y, Burgu B, Özden E, Tekgül S. Dysfunctional voiding and incontinence scoring system: quantitative evaluation of incontinence symptoms in pediatric population. J Urol. 2005; 173:969-73.
  • 8. McKenna PH. Current role of biofeedback for pediatric lower urinary tract symptoms. J Urol 2015; 193:14-5.
  • 9. Tugtepe H, Thomas DT, Ergun R et al. Comparison of biofeedback therapy in children with treatment-refractory dysfunctional voiding and overactive bladder. Urology. 2015; 85: 900-904.
  • 10. Khen-Dunlop N, Van Egroo A, Bouteiller C, Biserte J, Besson R. Biofeedback therapy in the treatment of bladder overactivity, vesico-ureteral reflux and urinary tract infection. J Pediatric Urol. 2006; 2: 424-29.
  • 11. Zeng F, Chen HQ, Qi L, Zhang XY, Li Y. Comparative study of pelvic floor biofeedback training and tolterodine for treatment of detrusor after-contraction in posturination dribbling in children. J Int Med Res. 444 2012; 40: 2305-10.
  • 12. Ladi-Seyedran S, Kajbafzadeh AM, Sharifi-Rad L, Shadgan B, Fan E. Management of non-neuropathic underactive bladder in children with dysfunctional voiding by animated biofeedback: A randomized clinical trial. Urology. 2015;85: 205-210.
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm ORIGINAL ARTICLES
Yazarlar

Emel Isıyel 0000-0001-9364-6473

Elif Çomak Bu kişi benim 0000-0002-2359-1961

İlkay Er Bu kişi benim 0000-0003-4562-3829

Yayımlanma Tarihi 16 Mart 2022
Gönderilme Tarihi 12 Ocak 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 16 Sayı: 2

Kaynak Göster

Vancouver Isıyel E, Çomak E, Er İ. The Role of Biofeedback Treatment in Children with Lower Urinary Tract Dysfunction. Türkiye Çocuk Hast Derg. 2022;16(2):117-20.

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