Evaluating the Benefits of Pelvic Floor Muscles Exercises Combined With Biofeedback Therapy for Improving Functional Urinary Incontinence in Children.

Abstract

Background: Pelvic floor muscles training (PFMT), with or without biofeedback (BF), is widely utilized as an alternative treatment for various refractory lower urinary tract dysfunctions in adults and children. This study aimed to compare the efficacy of PFMT alone versus in combination with BF on functional urinary incontinence (UI) in children.

Patients and methods: Medical records of children who had undergone pelvic floor rehabilitation for non-neuropathic intermittent UI from 2018 to 2022 were retrieved. Patients were categorized based on their treatment regimen. Group I had undergone standard urotherapy and PFMT, twice weekly for 5 weeks. Group II had undergone a similar 5-week treatment with addition of 10 BF sessions conducted at the end of each appointment. All children had been evaluated with kidney and bladder ultrasounds, uroflowmetry/EMG, and a 7-day voiding and bowel diary before and after treatment. Response to treatment was defined according to International Children's Continence Society (ICCS) protocols.

Results: A total of 32 patients (71.9% female) with a mean age of 8.4 ± 2.1 (range: 5-13) years were included in the analyses (each group N = 16). In group I, nine (56.2%) and two (12.5%) patients demonstrated complete (100% reduction in UI episodes) and partial (50%-100% reduction in UI episodes) clinical response, respectively. In group II, 11 (68.7%) and 3 (18.8%) patients showed complete and partial response, respectively. The two groups were not significantly different with regard to clinical response (p = 0.430). No significant difference was observed between the two groups in terms of enuresis, urgency, constipation, and uroflowmetry parameters.

Conclusions: PFMT under the supervision of an expert physical therapist appears to be as effective as combined PFMT and BF in improving UI in children without underlying neurologic disease.