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Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a randomized study

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Abstract

Fifty-six patients 5.9–15.2 years old with dysfunctional elimination syndrome (DES) unimproved by previous therapies were randomly distributed into two voiding training programs: group 1 contained 26 patients submitted to 24 training sessions over a 3-month period; group 2 contained 30 patients submitted to 16 sessions over a 2-month period. Both groups adhered to a voiding and drinking schedule, received instruction on adequate toilet posture, were reinforced through the maintenance of voiding diaries, and went through proprioceptive and pelvic floor muscle training (Kegel exercises). Group 2 patients also received biofeedback therapy. Clinical evaluation was carried out before each program’s initiation and 1, 6, and 12 months after each program’s termination. All patients were submitted to renal ultrasonography and dynamic ultrasonography before and 6 months after each program’s conclusion. Millivoltage recordings of pelvic floor muscles were compared before and after training. Urinary continence was improved after completion of either training program. Only those patients who received biofeedback training showed a significant decrease in postvoiding residual (PVR) urine as detected by dynamic ultrasonography. Our results show that either training regime can reduce episodic urinary incontinence and urinary tract infection but that further study is required to identify the optimal training duration.

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Acknowledgements

We extend grateful thanks to E. Baracho, PT, and Chris Fields for their generous help and contributions to the present study. This study was partially supported by the Brazilian National Research Council (CNPq) with Junia Araújo and Gisele Magnus the recipients of a CNPq fellowship.

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Authors and Affiliations

  1. Pediatric Nephrourology Unit, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Mônica Vasconcelos, Eleonora Lima, Letícia Caiafa, Alessandra Noronha, Renata Cangussu, Suzely Gomes, Raquel Freire, Maria Teresa Filgueiras & Cláudia Cunha

  2. Medical Students Recipients of Brazilian National Research Council (CNPq) Scholarship, Belo Horizonte, Brazil

    Junia Araújo & Gisele Magnus

  3. Department of Statistics, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Enrico Colozimo

Authors
  1. Mônica Vasconcelos
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  2. Eleonora Lima
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  3. Letícia Caiafa
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  4. Alessandra Noronha
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  5. Renata Cangussu
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  6. Suzely Gomes
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  7. Raquel Freire
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  8. Maria Teresa Filgueiras
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  9. Junia Araújo
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  10. Gisele Magnus
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  11. Cláudia Cunha
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  12. Enrico Colozimo
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Correspondence to Mônica Vasconcelos.

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Vasconcelos, M., Lima, E., Caiafa, L. et al. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a randomized study. Pediatr Nephrol 21, 1858–1864 (2006). https://doi.org/10.1007/s00467-006-0277-1

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  • DOI: https://doi.org/10.1007/s00467-006-0277-1

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