Objective. To compare the results of treating children with neurogenic and functional disorders of the urination act before and after training by the biofeedback (BF) method.
Materials and methods. The study enrolled 81 children aged 4 to 17 years (24 boys — 30%, 57 girls — 70%), the average age of children was 10.07±0.21 yrs.Two groups of patients were formed: Group 1 included 29 children (boys — 5, girls — 24) without proven localization of neurological pathology; group 2 — 52 children (boys — 19, girls — 33) with a confirmed source of neurological pathology. All patients were treated using the biofeedback method.
Results. As a result of the research, it was found that the maximum speed of urination increased during the training in the both groups of children. Children with dysfunctional voiding (DV) were able to maintain the faster speed until the next treatment session, where as the maximum speed fell back down to the baseline level in between treatment sessions in the children with a neurogenic bladder (NB).The residual volume (RV) decreased by the end of the training in the both groups but in the DV group the result was more stable and prolonged. At the beginning of training, vesicoureteral reflux (VUR),Gr. I-III was detected in 8 patients. At the end of treatment the state of 4 children (50%) improved.
Conclusion. Conducting of several training courses, on the average once every 6 months, resulted in a persistent improvement of urination in the both groups of patients. However, while in the DV groups, urination could be fully restored after several courses of training, children in the ND groups needed constant training to maintain the result. When the neurological symptoms deteriorate the biofeedback therapy is not effective, however, after the neurological status improvement, the training courses may be continued. This method can be used as the first-line therapy in cases where then vesicoureteral reflux and detrusor-external sphincter asynergia combined.
Автор(ы): A. Shybeka, Y. Suvorava, H. Druzhynin, V. Dubrov