Alt Üriner Sistem Disfonksiyonu Olan Çocuklarda Biyofeedback Tedavisinin Etkinliği

Amaç: Alt üriner sistem disfonksiyonu geniş spektrumlu bir tanıdır ve Uluslarararası Çocuk İşeme Topluluğuna göre aşırı aktif mesane, işemeyi erteleme, az aktif mesane, seyrek işeme, vajinal reflü, mesane boynu disfonksiyonu ve kıkırdama inkontinansını içerir. Biyofeedback kolay uygulanabilen, girişimsel olmayan ve normal mesane ve barsak fonksiyonlarının sağlanmasında pelvik duvar kaslarını aktive etmek için kullanılan bir tedavi yöntemidir. Bu çalışmada alt üriner sistem disfonksiyonu olan çocuklarda biyofeedback tedavisinin etkinliğinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya alt üriner sistem disfonksiyonu tanısı alan ve standart tedaviye yanıt vermeyen 29 hasta dahil edildi. Bu hastalara 8 hafta süre ile biyofeedback tedavisi uygulandı. Bulgular: Animasyon biofeedback tedavisinden sonra 13 hastada (%44.8) gündüz, iki (%6.8) hastada gece kaçırma şikayetleri düzeldi. Kabızlığı olan 5 hastada tamamen düzelme olmasına rağmen enkoprezisi olan hastalarda düzelme olmadı. Altı hastanın (% 20.7) şikayetlerinde azalma oldu ancak tam düzelme olmadı. Biofeedback tedavisi öncesi 16.19±7.69 olan ortalama işeme bozuklukları semptom skoru, tedavi sonrası 9.52±6.4’e geriledi ve istatistiksel olarak anlamlı bir fark (p<0.001£) saptandı. Sonuç: Çalışmamızdan elde ettiğimiz sonuçlara ve literatür taramalarına göre standart tedaviden fayda görmeyen alt üriner sistem disfonksiyonu olan çocuklarda biyofeedback tedavisi faydalı olabilir.

Anahtar Kelimeler:

Biyofeedback tedavisi, Standart tedavi, Alt üriner sistem disfonksiyonu

The Role of Biofeedback Treatment in Children with Lower Urinary Tract Dysfunction

Objective: Lower urinary tract dysfunction is a wide clinical spectrum and according to the International Children’s Continence Society, lower urinary tract dysfunction contains overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. Biofeedback is a non-invasive therapy that can be applied easily and aims to activate relevant pelvic wall muscles for normal bowel and bladder functions. This study aimed to evaluate the efficacy of biofeedback treatment in children with lower urinary tract dysfunction. Material and Methods: Twenty-nine patients who were diagnosed with lower urinary tract dysfunction and did not respond to standard therapy were included in the study. Biofeedback therapy was applied to these patients for 8 weeks. Results: After animation biofeedback treatment, daytime symptoms improved in 13 patients (44.8%), and nighttime enuresis improved in two (6.8%) patients. Although 5 patients with constipation completely improved, there was no improvement in patients with encopresis. There was a decrease but not a complete improvement in complaints of six patients (20.7%). Mean urinary incontinence symptom score which was 16.19±7.69 before biofeedback treatment decreased to 9.52±6.4 after the treatment, with a statistically significant difference (p<0.001). Conclusion: It was suggested that biofeedback treatment can be considered as a suitable alternative in children with dysfunctional urination who do not respond to standard treatment.

Keywords:

biofeedback treatment, Lower urinary tract dysfunction, standard urotherapy,

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