Abstract
The present study utilized EMG biofeedback in the treatment of functional bladder-sphincter dyssynergia, a learned incoordination of bladder and urethral sphincter activity during voiding. The condition is usually associated with a history of painful urination due to bladder infections, surgery, or harsh toilet training. The subject was an 8-year-old girl with chronic diurnal urinary frequency, urge incontinence, and nocturnal enuresis. Treatment consisted of intensive instruction in alternately tensing and relaxing her lower pelvic musculature, as well as relaxing during voiding. These exercises were accompanied by EMG biofeedback from perianal and perivaginal surface electrode sites. Home practice consisted of the tense-relax exercise, relaxation during voiding, and self-monitoring and record-keeping. There were 17 sessions over a period of 9 months. No medication was used. Marked reduction (to normal levels) in diurnal urgency and frequency occurred by the 3rd week of therapy, and complete recovery of normal function, including nocturnal continence without waking, occurred by the 13th therapy session, 5 months after therapy began. Follow-up 1 year after therapy revealed that these gains were being maintained. Pre- and posttherapy urodynamic studies corroborated the achievement of normal urinary function.
Similar content being viewed by others
References
Allen, T. A. The non-neurogenic neurogenic bladder.Journal of Urology 1977,117 232–238.
Cook, W. A., Firlit, C. F., Stephens, F. D., & King, L. R. Techniques and results of urodynamic evaluation of children.Journal of Urology 1977,117 346–349.
Firlit, C. F., & Cook, W. A. Voiding pattern abnormalities in children.Urology 1977,10 25–29.
Hinman, F. Urinary tract damage in children who wet.Pediatrics 1974,54 142–150.
Hinman, F., & Baumann, F. W. Vesical and ureteral damage from voiding dysfunction in boys without neurological or obstructive disease.Journal of Urology 1973,109 727–732.
Kegel, A. Stress incontinence of urine in women: Physiologic treatment.Journal of the International College of Surgeons 1956,25 487–499.
Maizels, M., King, L. R., & Firlit, C. F. Urodynamic biofeedback: A new approach to treat vesical sphincter dyssynergia.Journal of Urology 1979,122 205–209.
Pearne, D. H., Zigelbaum, S. D., & Peyser, W. P. Biofeedback-assisted EMG relaxation for urinary retention and incontinence: A case report.Biofeedback and Self-Regulation 1977,2 213–217.
Wear, J. B., Wear, R. B., & Cleeland, C. Biofeedback in urology using urodynamics: Preliminary observations.Journal of Urology 1979,121 464–468.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Libo, L.M., Arnold, G.E., Woodside, J.R. et al. EMG biofeedback for functional bladder-sphincter dyssynergia: A case study. Biofeedback and Self-Regulation 8, 243–253 (1983). https://doi.org/10.1007/BF00998854
Issue Date:
DOI: https://doi.org/10.1007/BF00998854