Ş. Kerem ÖZEL, Burhan AKSU, Murat MUTUŞ, Nilüfer GÖKNAR, Cengiz CANDAN, Çiğdem ULUKAYA DURAKBAŞA
Demiroğlu Bilim Üniversitesi Florence Nightingale Tıp Dergisi - 2026;12(1):11-19
Objectives: The aim of this study was to compare the effectiveness of biofeedback (BF) treatment, parasacral transcutaneous electrical nerve stimulation (PTENS), and dual combination in pediatric dysfunctional voiding (DV). Patients and methods: Between July 2018 and July 2021, a total of 42 participants diagnosed with DV were included in the prospective phase and divided into three groups: the BF group (1 male, 12 females; mean age: 9 +/- 3.28 years; range, 6 to 13 years), the PTENS (PT) group (2 males, 12 females; mean age: 8.85 +/- 2.14 years; range, 6 to 11 years), and the biofeedback and PTENS (BFPT) group (2 males, 13 females; mean age: 9.6 +/- 2.29 years; range, 5 to 16 years). Patients with DV were randomly selected for BF, PT, and BFPT. Standard urotherapy was applied to all patients. Patients were evaluated with uroflowmetry, residual urine levels, and an objective symptom scoring system, the International Consultation on Incontinence Questionnaire Pediatric Lower Urinary Tract Symptoms, before and after treatment. Late follow-up evaluations were also done. Results: No difference was observed in uroflowmetric data. Although the symptom scores decreased significantly in all groups after treatment (p for BF: 0.005, p for PT: 0.0001, p for BFPT: 0.001), the posttreatment score after PT was significantly lower when compared to the score after BF (17.46 +/- 3.23 vs. 14.5 +/- 3.59, p = 0.018). Long-term follow-up was 23.11 +/- 0.78 months for the BF group and 17.6 +/- 1.51 months for the PT group. These scores remained similar in long-term follow-up. Conclusion: Parasacral TENS seems to be more effective as a primary treatment in patients with DV in the short and long-term compared to BF treatment. It may be more advantageous in patients who cannot cooperate, have inadequate motivation, or have mental retardation. Thus, PT should be kept in mind in patients with DV.
