Biofeedback Therapy for Dysfunctional Voiding in Children

The past decade has seen a dramatic shift in the management of lower urinary tract dysfunction, including dysfunctional voiding, in children. Once treated primarily with medication, dysfunctional voiding now is managed successfully in most cases with noninvasive evaluations and biofeedback-based pelvic floor muscle retraining. Introduced in 1979, biofeedback initially was expensive and labor intensive, requiring inpatient treatment. The use of animated computer games has expedited results, allowing excellent resolution of dysfunctional voiding and coexisting conditions such as vesicoureteral reflux and constipation with outpatient treatment. Morbidity from medications and surgical procedures has been reduced at centers using biofeedback. Future goals of biofeedback therapy should include further refinements in technique and increasing access to care.