Which One Is More Effective for Lower Urinary Tract Dysfunctions in Children? Pelvic Floor Contraction or Pelvic Floor Relaxation in Biofeedback Therapy/Alt Uriner Sistem Disfonksiyonlu Cocuklarda Hangisi Daha Etkili Bir Tedavi Yontemidir? Biofeedback Tedavisinde Pelvik Taban Kasilmasi veya Pelvik Taban Gevsemesi

• Published in: Journal of urological surgery 2020-09, Vol.7 (3), p.211
• Main Authors: Kopru, Burak, Ebiloglu, Turgay, Ergin, Giray, Kaya, Engin, Kibar, Yusuf
• Format: Article
• Language: English
• Subjects: Biofeedback
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.galenos.2020.3054

Objective: The objective of this study is to investigate the results of contraction- and relaxation-based biofeedback (BF) in children with lower urinary tract dysfunction (LUTD). Materials and Methods: Between 2007 and 2017, we randomly directed children with the diagnosis of LUTD and refractory to standard urotherapy modifications via BF by using two different animations: animation A with relaxation nature BF (RBF) and animation B with contraction nature BF (CBF). The categories of non-response, partial response, and full response were defined as a 0-49% decrease, 50-99% decrease, and 100% decrease in the LUTD Symptom score, respectively. Results of biofeedback using RBF or CBF were compared. Results: There were 100 and 70 children in the RBF and CBF groups, respectively. Patients with an abnormal voiding pattern (abnormalVP) and a positive electromyography (EMG) activity (positive EMG) had a better resolution with RBF (p=0.001), whereas patients with abnormalVP and a negative EMG activity (negative EMG) had a better resolution with CBF (p=0.039). Despite being statistically insignificant, patients with a normal voiding pattern (normalVP) and positive EMG had a better resolution with CBF (p=0.452), whereas patients with normalVP and negative EMG had a better resolution with RBF (p=0.083). Conclusion: The EMG activity identifies the BF nature in children with LUTD and abnormalVP. Importantly, positive EMG had better results with RBF, whereas negative EMG had better results with CBF. Keywords: LUTD, Biofeedback, EMG activity, Voiding pattern, Contraction, Relaxation Amac: Alt uriner sistem disfonksiyonu (AUSS) olan cocuklarda kasilma ve gevseme bazli biofeedback (BF) sonuclarinin arastirilmasi amaclandi. Gerec ve Yontem: 2007-2017 yillari arasinda AUSS tanisi alan ve standart uroterapi tedavisine direncli olan cocuklar iki farkli animasyon kullanilarak rastgele BF'ye yonlendirildi: Animasyon A gevseme niteliginde BF (RBF) ve animasyon B kontraksiyon niteliginde BF (CBF) idi. Cevap vermeme, kismi cevap ve tam cevap, AUSS'de sirasiyla %0 ila %49 dusus, %50 ila %99 dusus ve %100 dusus olarak tanimlandi. RBF veya CBF kullanan biofeedback sonuclari karsilastirildi. Bulgular: RBF ve CBF grubunda sirasiyla 100 ve 70 cocuk vardi. Hastalarda anormal iseme akimi (abnormalVP) ve pozitif EMG aktivitesi (positive EMG) olan hastalarda RBF ile daha anlamli iyilesme (p=0,001); anormalVP ve negatif EMG aktivitesi (negative EMG) olan hastalar CBF ile daha anlamli iyilesmeye