Biofeedback Helps Kids Control Bladder

NEW YORK (Reuters Health) - Biofeedback can help children who wet the bed or who have other bladder problems, Turkish researchers report, and can even be effective in children as young as 5 years old.

Urinary problems often are due to poor control over contraction of the pelvic floor muscles, which interferes with normal bladder function, Dr. Sezgin Yagci of Gulhane Military Medical Academy in Ankara and colleagues note. Biofeedback techniques are an accepted treatment approach for pediatric patients with voiding problems of this type, they point out in the Journal of Urology.

In the current study, Yagci and his team evaluated biofeedback training in a group of 188 children with voiding problems, including wetting during the day and recurrent bladder infections. Children from families with psychological problems and those with neurological or bladder muscle abnormalities were not included in the study.

The researchers used a system that allowed for recording and visual display of urine flow and pelvic muscle activity. Children were instructed to contract and relax the urinary sphincter several times. A visual display represented the muscle activity, with a column of light that changed lengths as the muscles contracted and relaxed.

The children, who ranged in age from 5 to 14 years, underwent the training weekly, and were told to perform the exercises themselves at home. Sessions were scheduled every three to four weeks once the children understood the concept of biofeedback training and exercised at home regularly. The training lasted for a total of six months.

The researchers evaluated the children at six months and two years after the completion of training.

All but 20 of the original group completed the study. All parameters, which included both subjective and objective measures, showed improvement at six months.

For example, 81 percent showed a 90-percent improvement in bed-wetting as reported by their parents, while 59.2 percent of patients with daytime wetting showed the same degree of improvement. Recurrent urinary tract infections improved in 85 percent of patients, while bladder overactivity improved in 80.4 percent of patients.

At two years, the rate of improvement for several parameters, including bed-wetting and urinary tract infection, had increased, while for others, including daytime wetting, it decreased.

"Biofeedback training is a simple, effective and well-tolerated treatment" in children for with bladder problems, the researchers conclude, noting that it is important to select patients -- and parents -- who are motivated to participate in the training.

SOURCE: Journal of Urology, November 2005.