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ArtigoDireito Autoral
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- IFF - Artigos de Periódicos [1282]
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HIGH-INTENSITY, SHORT-TERM BIOFEEDBACK IN CHILDREN WITH HINMAN’S SYNDROME (NON-NEUROPATHIC VOIDING DYSSYNERGIA)
Voiding Dysfunction
Biofeedback
Urinary Incontinence
Non-Neuropathic
Voiding Dyssynergia
Non-Neurogenic
Neurogenic Bladder
Afiliação
Children National Medical Center. Division of Urology. Washington DC, USA. / Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Laboratório de Urodinâmica Pediátrica. Rio de Janeiro, RJ, Brasil.
Children National Medical Center. Division of Urology. Washington DC, USA.
Children National Medical Center. Division of Urology. Washington DC, USA.
Children National Medical Center. Division of Urology. Washington DC, USA.
Children National Medical Center. Division of Urology. Washington DC, USA.
Children National Medical Center. Division of Urology. Washington DC, USA.
Children National Medical Center. Division of Urology. Washington DC, USA.
Resumo em Inglês
Objective:To evaluate the long-term response to high-intensity, short-term biofeedback in children with severe voiding dysfunction.
Patients and methods:We retrospectively reviewed patients who underwent short-term, high-intensity biofeedback therapy from 1996 to 2004. Improvement was
classified based on clinical and radiographic findings. Patients were categorized
as having Hinman’s syndrome when, in addition to urinary incontinence, at least
four of the following categories were present: sphincter dyssynergia, bladder tra-beculation, large post-void residual (PVR), hydronephrosis, vesicoureteral reflux
(VUR) and urinary tract infections. There were 14 patients (eight males and six
females), 13 of whom had Hinman’s syndrome. Age when biofeedback was initiated
varied from 5.6 to 12.9 years (m¼8.9 2.2). Before biofeedback, all had large
PVRs, bladder trabeculation and sphincter dyssynergia. Nine had hydronephrosis
and five had VUR. One patient had renal failure.
Results:Before biofeedback, the mean PVR was 109 ml (25e270 ml); after biofeed-back, this decreased to 21 ml (0e150 ml), including two patients who eventually
failed treatment. All 14 patients were able to relax their external sphincter and
reduce the PVR during biofeedback and on short-term follow up. Long-term follow
up (m¼59.4 months) in 12 patients established that seven had a durable response
with remission of symptoms, reduced PVR and radiographic improvement. In three,
symptoms partially recurred over time and two failed treatment completely. Conclusion:Short-term, high-intensity biofeedback achieves a durable response in
the majority of children with Hinman’s syndrome. Long-term follow up is needed to
assure compliance.
Palavras-chave em inglês
Hinman’s SyndromeVoiding Dysfunction
Biofeedback
Urinary Incontinence
Non-Neuropathic
Voiding Dyssynergia
Non-Neurogenic
Neurogenic Bladder
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