| ORIGINAL ARTICLE
|Year : 2022 | Volume
| Issue : 4 | Page : 466-472
Noninvasive evaluation of bladder bowel dysfunction and its extrapolation as biofeedback therapy to train pelvic floor muscles
Gaurav Shandilya1, Prabhu Karunakaran1, Abhishek Pathak2, Priyank Yadav2, Aneesh Srivastava2, MS Ansari2
1 Department of Urology and Renal Transplant, SGPGIMS, Lucknow, Uttar Pradesh, India
2 Department of Urology, SGPGIMS, Lucknow, Uttar Pradesh, India
Aims: This study aimed to evaluate the noninvasive methods to diagnose bladder bowel dysfunction (BBD) and its extrapolation on biofeedback therapy and pelvic floor exercises (PFE) to treat these children.
Settings and Design: A retrospective cohort study at a tertiary care center was conducted between January 2010 and December 2020, on 204 children, aged 4–18 years, arbitrarily divided into two groups-4–12 and 13–18 years.
Subjects and Methods: Details of lower urinary tract dysfunction were recorded as International Children's Continence Society nomenclature. Bowel habits were recorded and functional constipation was graded using ROME IV. The data recorded were urine analysis, a voiding diary, a dysfunctional voiding symptom score, and uroflowmetry with or without electromyography. Ultrasonography, voiding cystourethrogram, and magnetic resonance imaging were done in appropriate cases. Dysfunctional Voiding Severity Score was used to assist the evaluation and outcome. The treatment protocol included urotherapy, uroflow biofeedback, PFEs, prophylactic antibiotics, pharmacotherapy, and treatment of constipation.
Statistical Analysis Used: Statistical analysis was done using SPSS version 26 and paired t-test was used for comparison and calculating P value.
Results: There was a significant improvement in DVSS and uroflow parameters. However, the magnitude of change produced varied among the age groups. Patients who failed to show any clinical benefit were subjected to alternative therapies such as intrasphincteric Botulinum A toxin with or without neuromodulation.
Conclusions: Integrated uroflow biofeedback (IUB) and PFE expedites the recovery by supplementing the effect of urotherapy; hence, this should be offered to all children with BBD.
M S Ansari
Department of Urology, SGPGIMS, Lucknow - 226 014, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
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