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The Role of Physical Therapy in the Treatment of Pediatric Bladder Dysfunction

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Abstract

Purpose of Review

The purpose of this review is to summarize current literature related to the pediatric physical therapist’s role in the treatment of lower urinary tract dysfunction (LUTD). Common intervention strategies include standard urotherapy (SU), biofeedback (BF), transcutaneous electrical nerve stimulation (TENS), interferential (IF) electrical stimulation, group therapy/voiding school, and pelvic floor physical therapy (PFPT).

Recent Findings

SU is considered the gold standard, first-line treatment for children with LUTD and should be initiated by the child’s primary care provider or urologist. Pelvic floor physical therapists can aid in reenforcing SU education and perform secondary interventions including BF, TENS, IF electrical stimulation, group therapy, and specific pelvic floor muscle training.

Summary

Children with LUTD should be managed with a multidisciplinary approach, which may include PFPT. While PFPT has a role in the management of these patients, further research is needed to determine when a referral to a PFPT is warranted and to guide clinical decisions.

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Abbreviations

BF:

Biofeedback

BBD:

Bowel and bladder dysfunction

DUI:

Daytime urinary incontinence

DV:

Dysfunctional voiding

EMG:

Electromyography

GI:

Giggle incontinence

IF:

Interferential

ICCS:

International Children’s Continence Society

ICF:

International classification of functioning

IAP:

Intra-abdominal pressure

LUTD:

Lower urinary tract dysfunction

NE:

Nocturnal enuresis

OAB:

Overactive bladder

PFM:

Pelvic floor muscles

PFPT:

Pelvic floor physical therapy

PVR:

Post-void residual

RCT:

Randomized control trial

SU:

Standard urotherapy

TENS:

Transcutaneous electrical nerve stimulation

UTI:

Urinary tract infections

VUR:

Vesicoureteral reflux

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Authors and Affiliations

  1. Department of Pediatric Rehabilitation, Monroe Carell Jr. Children’s Hospital at Vanderbilt, 719 Thompson Lane, Suite 21000, Nashville, TN, 37204, USA

    Megan L. Hartless & Macey Martin

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  1. Megan L. Hartless
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Contributions

M. H. and M. M. wrote the main manuscript text and prepared all tables. Both authors reviewed the manuscript.

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Correspondence to Megan L. Hartless.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Hartless, M.L., Martin, M. The Role of Physical Therapy in the Treatment of Pediatric Bladder Dysfunction. Curr Bladder Dysfunct Rep 18, 352–360 (2023). https://doi.org/10.1007/s11884-023-00709-3

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