We assessed efficacy of biofeedback therapy and home pelvic floor muscle exercises in children with dysfunctional voiding (DV) associated with mild to moderate hydronephrosis. This prospective study comprised fifty seven children (21 boys, 36 girls; mean age 8.9 ± 2.6) with DV and mild to moderate hydronephrosis. Children were randomly allocated into two treatment groups including control group who underwent standard urotherapy and case group who received biofeedback therapy in addition to standard urotherapy. A 99mTc diethylenetriamine pentaacetic acid (99mDTPA) scan, voiding cystoureterography, kidney and bladder ultrasounds, voiding diary and uroflowmetry with electromyography (EMG) were performed in all study participants at the baseline. Children with evidence of complete obstruction in DTPA scan and vesicoureteral reflux were excluded from enrollment. A complete voiding diary, kidney and bladder ultrasounds and uroflowmetry/EMG were also performed 6 months and 1 year after completion of the treatment. We noted a more significant decline in anteroposterior pelvic diameter in case group compared to control group (P < 0.05). The mean maximal urine flow rate prior to treatment was 16.5 ± 2.6 and 16.1 ± 3 ml/s in case and control groups, respectively. This finding increased significantly 1 year after the treatment in case group compared to controls (25 ± 7.2 ml/s vs. 18.4 ± 5.9 ml/s, respectively; P < 0.001). Improvement of various parameters in voiding diary was also more significant in the case group. Biofeedback therapy can effectively resolve non-refluxing and non-obstructive hydronephrosis in children with DV.

我们评估了生物反馈疗法和家庭盆底肌肉锻炼对伴有轻度至中度肾积水的排尿功能障碍 (DV) 儿童的疗效。这项前瞻性研究包括 57 名患有 DV 和轻度至中度肾积水的儿童（21 名男孩，36 名女孩；平均年龄 8.9 ± 2.6 岁）。儿童被随机分配到两个治疗组，包括接受标准尿路治疗的对照组和在标准尿路治疗之外接受生物反馈治疗的病例组。在基线时对所有研究参与者进行了 99mTc 二亚乙基三胺五乙酸 (99mDTPA) 扫描、排尿膀胱输尿管造影、肾脏和膀胱超声、排尿日记和肌电图 (EMG) 尿流测量。有证据表明 DTPA 扫描完全梗阻和膀胱输尿管反流的儿童被排除在招募之外。完成治疗后 6 个月和 1 年还进行了完整的排尿日记、肾脏和膀胱超声检查以及尿流测量/肌电图检查。我们注意到与对照组相比，病例组的骨盆前后径下降更显着。P  < 0.05)。在病例组和对照组中，治疗前的平均最大尿流速分别为 16.5 ± 2.6 和 16.1 ± 3 ml/s。与对照组相比，病例组治疗 1 年后这一发现显着增加（分别为 25 ± 7.2 ml/s 和 18.4 ± 5.9 ml/s；P  < 0.001）。排尿日记各项参数的改善在病例组中也更为显着。生物反馈疗法可有效解决DV患儿的非反流、非梗阻性肾积水。