Biofeedback is a technique that helps children identify and become aware of the muscles that they can use to control their urination. Muscle contraction is intended to prevent urine leakage, while relaxation aims to facilitate proper bladder emptying.
The biofeedback technique is effective in addressing various issues related to bladder control. Children who might benefit include those who -
- struggle with complete bladder emptying
- exert effort to urinate
- suffer from recurrent urinary tract infections
- experience urgency in urination (difficulty holding back)
- continue to experience bedwetting despite other treatment attempts
The technique is performed by attaching two small adhesive sensors to both sides of the pelvic floor muscles and one adhesive sensor in the lower abdomen area. The sensors are connected to a computer that translates the child's muscle contractions and relaxations into visual cues displayed on the screen as a game.
The visual cues change as the child contracts and relax the pelvic floor muscles (the sphincters). This initiates a process of learning how to identify and effectively control the correct muscles, contracting and relaxing appropriately.
The technique does not replace other treatments for enuresis but rather provides significant support to the range of treatments.
Pre-assessment before starting biofeedback treatment:
Before beginning biofeedback treatment, a uroflow test is performed (to measure the force and flow of the urine stream). This requires that the child arrive at the clinic with a full bladder:
- Children under the age of 7 should drink 2 cups of water one hour before the test.
- Children aged 7 and above should drink 3 cups of water one hour before the test.
Certain foods may affect the assessment results, so on the evening before and the morning of the assessment, the following should be avoided:
- Caffeine
- Carbonated beverages
- Fruits, especially citrus fruits
- Chocolate
- Dairy products (milk, cheese, yogurts, dairy ice cream)
Bowel movements:
Constipation affects the relaxation of pelvic floor muscles.
Even if your child has regular daily bowel movements, there may be a buildup of stool in the intestines. Ideally the session should take place after your child has had a bowel movement in the morning of the same day, or the night before.
A voiding diary should be maintained with an entry once a month, and home exercises should be performed in strict accordance with the training chart (the voiding diary and training chart will be explained by the clinic team).
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