BERKELEY, CA (UroToday.com) - Functional voiding disorders account for as many as 40% of pediatric urology clinic visits with dysfunctional voiding affecting the voiding phase of the micturition cycle.
According to the 2006 International Children’s Continence Society (ICCS), in defining the terminology of lower urinary tract function in children, it is characterized by an intermittent and/or fluctuating uroflow rate due to involuntary intermittent contractions of the striated muscle of the external urethral sphincter or pelvic floor, during voiding, in neurologically normal individuals. Symptoms vary from mild daytime frequency and urgency to daytime and nighttime wetting, pelvic floor holding maneuvers, voiding difficulties, urinary tract infections, constipation, and vesicoureteral reflux.
| "We believe that our program will be recognized in other centers dedicated to the treatment of dysfunctional voiders. It rises new hopes and insights into the treatment possibilities of these children." |
Until now, rehabilitation programs concentrated primarily on the pelvic floor muscles and recognition of their function and relaxation. In this study we emphasized that the pelvic floor muscles are part of the abdominal capsule and that they act in coordination with lower abdominal muscles. Dysfunctional voiders had an overactive abdominal wall that was not released during voiding to allow for the relaxtion of pelvic floor muscles. The easiest way to teach children how to relax abdominal muscles was through diaphragmatic breathing exercises. During diaphragmatic inspiration the anterior abdominal wall is relaxed as it is buldged outward by the compression of abdominal organs by the descending diaphragm.
This study is unique because it showed a different concept of treating dysfunctional voiders. Examination of lower abdominal muscles, recognition of their function during voiding, and their relaxation should be incorporated into the treatment program of these children. Easy to learn diaphragmatic breathing exercises do not require any specific equipment and can be performed at all health care levels. Children from five years of age could benefit from these exercises.
We believe that our program will be recognized in other centers dedicated to the treatment of dysfunctional voiders. It rises new hopes and insights into the treatment possibilities of these children.
Written by:
Vesna Zivkovic, MD, PhD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Specialist of Physical and Rehabilitation Medicine
Clinic of Physical and Rehabilitation Medicine
Clinical Centre Nis
Serbia
Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding - Abstract
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