Abstract
Eight children with myelomeningocele and chronic neurogenic urinary incontinence were provided urodynamic biofeedback training. During urodynamic biofeedback, six of the eight children demonstrated improved self-regulation of detrusor and/or sphincter functioning. However, substantial improvements in clinical symptomatology (i.e., urinary incontinence) were clearly shown by only one child. Unexpectedly, chronic neurogenic fecal incontinence was reduced in four children. Several methodological modifications are discussed which may improve clinical symptomatology and which may facilitate further urodynamic biofeedback research for these children with congenital neurogenic urinary incontinence.
Similar content being viewed by others
References
Allen, T. D. (1977). The non-neurogenic neurogenic bladder.Journal of Urology, 117 232–238.
Austin, E. S., Lindgren, W. D., & Dietrich, S. L. (1972). Spina bifida and myelomengingocele.American Family Physician, 6 105–111.
Cardozo, L. D., Abrams, P. D., Stanton, S. L., & Fenely, R. C. L. (1978). Idiopathic bladder instability treated by biofeedback.British Journal of Urology, 50 521–523.
Cardozo, L., Stanton, S. L., Hafner, J., & Allan, V. (1978). Biofeedback in the treatment of detrusor instability.British Journal of Urology, 50 250–254.
Feldman, W. S., Manella, K. J., Apodaca, L., & Varni, J. W. (1982). Behavioral group parant training in spina bifida.Journal of Clinical Child Psychology, 11 144–150.
Feldman, W. S., Manella, K. J., & Varni, J. W. (1983). A behavioral parent training program for single mothers of physically handicapped children.Child Care, Health and Development, 9 157–168.
Feldman, W. S., & Varni, J. W. (1985). Conceptualizations of health and illness by children with spina bifida.Children's Health Care, 13 102–108.
Hanna, M. K., DiScipio, W., Suh, K. K., Kogan, S. J., Levitt, S. B., & Donner, K. (1981a). Urodynamics in children: Part I. Methodology.Journal of Urology, 125 530–533.
Hanna, M. K., DiScipio, W., Suh, K. K. Kogan, S. J., Levitt, S. B., & Donner, K. (1981b). Urodynamics in children: Part II. The pseudoneurogenic bladder.Journal of Urology, 125 534–537.
Hayden, P. W., Davenport, S. L., & Campbell, M. M. (1979). Adolescents with myelodysplasia: Impact of physical disability on emotional maturation.Pediatrics, 64 53–59.
Hunt, G. M. (1981). Spina bifida: Implications for 100 children at school.Developmental Medicine and Child Neurology, 23 160–172.
Jeffries, J. S., Killam, P. E., & Varni, J. W. (1982). Behavioral management of fecal incontinence in a child with myelomeningocele.Pediatric Nursing, 8 267–270.
Killam, P. E., Apodaca, L., Manella, K. J., & Varni, J. W. (1983). Behavioral pediatric weight rehabilitation for children with myelomeningocle.MCN: American Journal of Maternal Child Nursing, 8 280–286.
Lorber, J. (1971). Results of treatment of myelomeningocele.Developmental Medicine and Child Neurology, 13 279–303.
Maizels, M., King, L. R., & Firlit, C. F. (1979). Urodynamic biofeedback: A new approach to treat vesical sphincter dyssynergia.Journal of Urology, 122 205–209.
Manella, K. J., Jeffries, J. S., & Varni, J. W. (1984, May).Adherence to health care behaviors in the prevention of pressure sores by adolescents with spina bifida. Paper presented at the Annual Meeting of the Society of Behavioral Medicine, Philadelphia.
Manella, K. J., & Varni, J. W. (1981). Behavior therapy in a gait-training program for a child with myelomeningocele.Physical Therapy, 61 1284–1287.
Manella, K. J., & Varni, J. W. (1984). Behavioral treatment of ambulatory function in a child with myelomeningocele.Physical Therapy, 64 1536–1539.
Reuler, J. B., Cooney, T. G. (1981). The pressure sore: Pathophysiology and principles of management.Annals of Internal Medicine, 94 661–666.
Schneider, R. D., & Westendorf, K. (1979). Adjuvant bladder-pressure biofeedback in treating neurogenic bladder dysfunction: A case study.Behavior Therapist, 2 29–31.
Shurtleff, D. B. (1980). Myelodysplasia: Management and treatment.Current Problems in Pediatrics, 10 7–41.
Shurtleff, D. B., Hayden, P. W., Chapman, W. H., Bnoy, A. B., & Hill, M. H. (1975). Myelodysplasia: Problems of long-term survival and social function.Western Journal of Medicine, 122 199–205.
Varni, J. W. (1983).Clinical behavioral pediatrics: An interdisciplinary biobehavioral approach New York: Pergamon Press.
Wald, A. (1981). Use of biofeedback in treatment of fecal incontinence in patients with myelomeningocele.Pediatrics, 68 45–49.
Wear, J. B., Wear, R. B., & Cleeland, C. (1979). Biofeedback in urology using urodynamics: Preliminary observations.Journal of Urology, 121 464–468.
Webster, G. D. (1982). Urodynamic studies. In M. I. Resnick & R. A. Older (Eds.),Diagnosis of diseases of the genitourinary system New York: Thieme-Stratton.
Whitehead, W. E., Parker, L. H., Masek, B. J., Cataldo, M. F., & Freeman, J. M. (1981). Biofeedback treatment of fecal incontinence in patients with myelomeningocele.Developmental Medicine and Child Neurology, 23 313–322.
Author information
Authors and Affiliations
Additional information
This work was supported by a grant from The Crippled Children's Guild through the Behavioral Pediatrics Program at Orthopaedic Hospital.
Rights and permissions
About this article
Cite this article
Killam, P.E., Jeffries, J.S. & Varni, J.W. Urodynamic biofeedback treatment of urinary incontinence in children with myelomeningocele. Biofeedback and Self-Regulation 10, 161–171 (1985). https://doi.org/10.1007/BF01000751
Issue Date:
DOI: https://doi.org/10.1007/BF01000751