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Improvement of Lower Urinary Tract Dysfunction Symptoms After Three Sessions of Biofeedback

Jacqueline Guarino Broda, PA-C Physician Assistant, Department of Urology Texas Children’s Hospital Clinical Assistant Professor Baylor College of Medicine. Improvement of Lower Urinary Tract Dysfunction Symptoms After Three Sessions of Biofeedback. Disclosures. None. Objectives.

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Improvement of Lower Urinary Tract Dysfunction Symptoms After Three Sessions of Biofeedback

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  1. Jacqueline Guarino Broda, PA-C Physician Assistant, Department of Urology Texas Children’s Hospital Clinical Assistant ProfessorBaylor College of Medicine Improvement of Lower Urinary Tract Dysfunction Symptoms After Three Sessions of Biofeedback

  2. Disclosures • None

  3. Objectives • Define lower urinary tract symptoms (LUTS) and biofeedback therapy • Summarize evaluation of LUTS • Review the impact of 3 sessions of biofeedback on LUTS

  4. Hypothesis Three sessions of biofeedback will reduce lower urinary tract symptoms (LUTS) 3

  5. International Children’s Continence Society 20-30%

  6. Lower Urinary Tract Dysfunction DYSFUNCTIONAL VOIDING OVERACTIVE BLADDER Over distention Dyssynergy

  7. Storage Symptoms • Voiding frequency • Incontinence • Continuous vs. Intermittent • Daytime incontinence • Enuresis • Urgency • Nocturia Voiding Symptoms • Hesitancy • Straining • Weak stream • Intermittency • Dysuria

  8. Urotherapy • Education • Timed voiding • Double voiding • Correct posture • Increase water intake • Control constipation • Diary Recording

  9. Biofeedback • Noninvasive • Real time feedback of abdominal and perineal muscle use • Requires cooperation and compliance • Time consuming/ costly

  10. 4 6 12

  11. No UTIs, dry days and nights, and normal voiding frequency of 4-5 times daily Fewer UTIs, dry day or nights, and more appropriate urinating times UTIs, persistent day and night wetting, no change in voiding frequency Success27% Improved38% Failure34%

  12. Methods • Retrospective review • April 2016 – September 2018 • Two-tailed Student’s t-test and X2test • Behavioral modifications and bowel management 159 patient undergoing biofeedback 113 completed 3 sessions of biofeedback 46 completed 3 sessions of biofeedback & questionnaire before & after

  13. Overall Symptom Score Improved 20.5 14.0

  14. Dysuria Improved (It hurts when I pee) 0 1 2 3 4

  15. Straining to Void/ Hesitancy Improved (I have to push or wait for my pee to start) 0 1 2 3 4

  16. Intermittent Flow Improved (When I pee, it stops and starts) 1 2 3 4 0

  17. Other Improvements

  18. No Significant Improvement/ Symptoms

  19. Storage Symptoms • Voiding frequency • Incontinence • Continuous vs. Intermittent • Daytime incontinence • Enuresis • Urgency • Nocturia Voiding Symptoms • Hesitancy • Straining • Weak Stream • Intermittency • Dysuria

  20. Conclusion Biofeedback Can be utilized with objective success in improving LUTS voiding scores in 3 sessions.

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