Outpatient pelvic-floor therapy in girls with daytime incontinence and dysfunctional voiding

Abstract

Objectives Analysis of an experience in treating girls with dysfunctional voiding with an outpatient pelvicfloor therapy consisting of voiding and drinking schedule, pelvic-floor relaxation biofeedback, instructions on toilet behavior, and uroflowmetry. Methods The files of 50 girls (between 6 and 13 years of age) with urodynamically proven dysfunctional voiding who participated in the training program were analyzed retrospectively. Thirty-five girls received anticholinergics during the entire course of the training. The long-term absence of diurnal incontinence was used as the criterion for the success of the therapy. The duration of treatment before reaching this success was used as a parameter to measure the intensity of therapy. For a portion of the study group, a comparison is made with the duration of the preceding therapies to demonstrate indirectly the cumulative effect of the pelvic floor therapy. Results Forty-six girls (92%) normalized their flow and bladder capacity after therapy and saw their daytime incontinence disappearing. All of these girls achieved this result in a maximum of 18 sessions within a 6month period. At the follow-up examination after 6 months, five of the girls had relapsed (10%), which brings the ultimate success after 6 months of follow-up to 82%. Conclusions Pelvic-floor therapy seems to be a reasonable and meaningful component in the treatment of bladder dysfunction in which detrusor-sphincter dyscoordination plays a role.