Dynamic transperineal ultrasonography as indication criteria for biofeedback therapy in children with dysfunctional voiding

Disorders of pelvic organs' evacuation function, manifested by difficulty in urination and constipation, in conjunction with incontinence, and childhood stool smearing is an urgent medical and social problem. The study presents results of treatment of 36 children (mean age 7,2 ± 2,3 years) with non-neurogenic variants of pelvic organ dysfunction. The choice of treatment was based on an attempt to form managed urination. Indications to treatment were defined both by traditional methods, and by transperineal ultrasonography - the method developed by the authors. Increased rear urethrovesical angle at rest and during functional tests with retention and straining, the deviation of the bladder neck and urethra to sacrum, shortening of urethra and bladder neck, lack of bladder neck and urethra movement, or the inability to perform volitional exercises were seen as signs of pelvic floor paradoxical movements. Analysis of the results of clinical trials showed, that the method is a reliable, non-invasive and does not require expert class ultrasound equipment. The treatment consisted of biofeedback therapy sessions performed in outpatient settings. 25 children were found to have positive changes, 7 of them fully recovered from voiding dysfunction.

children, evacuation dysfunction, transperineal ultrasound, biofeedback therapy