Biofeedback Pelvic Floor Muscle Training for Voiding Dysfunction and Overactive Bladder

mini1Original article
Received: January 1, 2007 Accepted: February 15, 2007 Address correspondence to: Dr. Hann-Chorng Kuo, Department of Urology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, Hualien, Taiwan E-mail: [email protected]
ABSTRACT Objective: Biofeedback pelvic floor muscle training (PFMT) has been widely used in treatment of stress urinary incontinence, idiopathic detru- sor overactivity, learned dysfunctional voiding and chronic pelvic pain. Only limited data have been reported on this treatment of overactive bladder (OAB) and voiding dysfunction in adults. This study used PFMT to treat a group of patients with symptoms of OAB or voiding dysfunction due to poor relaxation of the urethral sphincter or pelvic floor muscles. Materials and Methods: All patients were treated with a standard 12-week step by step program which included instruction in voiding physiology, identification of the pelvic floor muscles, correct contraction of the pelvic floor muscles, increase in endurance of the pelvic floor muscles, and a continuing program at home. The symptomatic improvement and uroflowmetry parameters were compared between baseline and post-PFMT. Results: A total of 124 patients entered this study, but only 68 (55%) completed the program. Among these patients, 52 (76.3%) had symptomatic improvement. After PFMT, the maximum flow rate and voided volume all increased in both genders and in patients with OAB as well as those with voiding dysfunction. Conclusions: The results of this study demonstrated that with a proper training program, 76.5% of patients with OAB and voiding dysfunction can achieve improvement in symptoms using biofeedback PFMT. The severity of frequency urgency symptoms can be reduced and voided volume and Qmax can be increased.
Key words: biofeedback, lower urinary tract symptoms, voiding dysfunction, overactive bladder
Biofeedback Pelvic Floor Muscle Training for Voiding Dysfunction and
Overactive Bladder
Yuan-Ming Liaw, M.D., Hann-Chorng Kuo, M.D. Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
Incont Pelvic Floor Dysfunct 2007;1:13-15
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Table 1. The Symptomatology of Lower Urinary Tract Symptoms in Patients Undergoing Biofeedback PFMT
Men (n=31) Women (n=37) Total (n=68)
Frequency 21 32 53 (78.0%) Urgency 7 19 26 (38.2%) Urge incontinence 2 7 9 (13.2%) Nocturia 17 12 29 (42.6%) Small caliber urine 18 8 26 (38.2%) Residual urine 15 18 33 (48.5%) Straining to void 4 7 11 (16.2%)
Table 2. The Uroflometry Data at Baseline and 3 Months after Biofeedback PFMT in Patients with OAB and Voiding Dysfunction
Qmax (mL/s) Voided volume (mL) PVR (mL)
Total (n=68) baseline 14 ± 7.5 256 ± 135 61 ± 70 Post-PFMT 19.5 ± 9.7 374 ± 144 41.3 ± 49.2 P value 0.000 0.000 0.037
Men (n= 31) baseline 10.5 ± 4.3 243 ± 148 70 ± 79.6 Post-PFMT 14.1 ± 4.7 375 ± 153 44.7± 42.1 P value 0.000 0.000 0.467
Women (n=37) baseline 17 ± 8.3 268 ± 124 53.3 ± 60.7 Post-PFMT 24 ± 10.5 373 ± 54.9 38.5 ± 54.9 P value 0.000 0.000 0.072
Table 3. The Uroflometry Data at Baseline and 3 Months after Biofeedback PFMT in Patients with OAB and Voiding Dysfunction
Qmax (mL/s) Voided volume (mL) PVR (mL)
OAB (n=26) baseline 14.4 ± 7.4 229 ± 125 58.1 ± 75.5 Post-PFMT 18.4 ± 9.7 332 ± 132 39.4 ± 45.7 P value 0.013 0.002 0.220
V.D. (n= 42) baseline 13.8 ± 7.6 273 ± 139 62.6 ± 67.1 Post-PFMT 20.2 ± 9.7 400 ± 146 42.4 ± 51.7 P value 0.000 0.000 0.266
V.D.: voiding dysfunction
Original article
Table 4. Changes of Uroflometry Data between Baseline and 3 Months in Patients with Successful and Failed Results after Biofeedback PFMT
Successful PFMT (n=52) Failed PFMT (n=16) P value
Qmax (mL/s) 7.5 ± 7.6 -1.1 ± 4.7 0.000 Voided volume (mL) 150 ± 122 12.9 ± 141 0.000 PVR (mL) -16.8 ± 75.1 -28.8 ± 80.7 0.585
Fig. 1. Uroflowmetry data in a girl with voiding dysfunction at baseline and after PFMT. The staccato flow patter at baseline (A) be- came a normal bell shape (B) af- ter PFMT. Qmax at baseline and after PFMT were similar.
(B)
(A)
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