Original article
Incont Pelvic Floor Dysfunct 2007;1:13-15
Biofeedback Pelvic Floor Muscle Training for Voiding Dysfunction and
Overactive Bladder
Yuan-Ming Liaw, M.D., Hann-Chorng Kuo, M.D.
Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
ABSTRACT
Objective: Biofeedback pelvic floor muscle training (PFMT) has been widely used in treatment of stress urinary incontinence, idiopathic detrusor overactivity, learned dysfunctional voiding and chronic pelvic pain. Only limited data have been reported on this treatment of overactive
bladder (OAB) and voiding dysfunction in adults. This study used PFMT to treat a group of patients with symptoms of OAB or voiding
dysfunction due to poor relaxation of the urethral sphincter or pelvic floor muscles. Materials and Methods: All patients were treated with a
standard 12-week step by step program which included instruction in voiding physiology, identification of the pelvic floor muscles, correct
contraction of the pelvic floor muscles, increase in endurance of the pelvic floor muscles, and a continuing program at home. The symptomatic
improvement and uroflowmetry parameters were compared between baseline and post-PFMT. Results: A total of 124 patients entered this study,
but only 68 (55%) completed the program. Among these patients, 52 (76.3%) had symptomatic improvement. After PFMT, the maximum flow
rate and voided volume all increased in both genders and in patients with OAB as well as those with voiding dysfunction. Conclusions: The
results of this study demonstrated that with a proper training program, 76.5% of patients with OAB and voiding dysfunction can achieve
improvement in symptoms using biofeedback PFMT. The severity of frequency urgency symptoms can be reduced and voided volume and
Qmax can be increased.
Key words: biofeedback, lower urinary tract symptoms, voiding dysfunction, overactive bladder
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Received: January 1, 2007 Accepted: February 15, 2007
Address correspondence to: Dr. Hann-Chorng Kuo, Department of Urology, Buddhist
Tzu Chi General Hospital, 707, Section 3, Chung Yang Road, Hualien, Taiwan
E-mail: hck@tzuchi.com.tw
NP
Original article
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Table 1.
^í=P=ãçåíÜë=~ÑíÉê=íÜÉ=áåáíá~ä=ÄáçÑÉÉÇÄ~Åâ=mcjqI=çåäó=SU=çÑ=íÜÉ=NOQ
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qÜáêíóJ=çåÉ=é~íáÉåíë=ïÉêÉ=ã~äÉë=~åÇ=PT=ïÉêÉ=ÑÉã~äÉëK=qïÉåíó=ëáñ=é~J
íáÉåíë=Ü~Ç=l^_=ëóãéíçãë=~åÇ=QO=Ü~Ç=îçáÇáåÖ=ÇóëÑìåÅíáçåK=qÜÉ=~ÖÉë
çÑ=íÜÉëÉ=SU=é~íáÉåíë=ê~åÖÉÇ=Ñêçã=V=íç=UP=óÉ~êë=ïáíÜ=~=ãÉ~å=çÑ=RR=± NR
óÉ~êë=çäÇK
qÜÉ=ëóãéíçã~íçäçÖó=çÑ=íÜÉ=é~íáÉåíë=áë=äáëíÉÇ=áå=q~ÄäÉ=NK=m~íáÉåíë
ïáíÜ=ã~áåäó=l^_=ëóãéíçãë=~äëç=Ü~Ç=ëçãÉ=ÇÉÖêÉÉ=çÑ=îçáÇáåÖ=ÇóëÑìåÅJ
íáçå=ïÜÉêÉ~ë=é~íáÉåíë=ïáíÜ=îçáÇáåÖ=ÇóëÑìåÅíáçå=~äëç=ã~ó=Ü~îÉ=Ü~Ç=ìêJ
ÖÉåÅó=ÑêÉèìÉåÅó=ëóãéíçãëK=^ÑíÉê=ÅçãéäÉíáçå=çÑ=ÄáçÑÉÉÇÄ~Åâ=mcjqI
RO=ETSKRBF=é~íáÉåíë=Ü~Ç=ëìÅÅÉëëÑìä=êÉëìäíë=ïÜáäÉ=NS=é~íáÉåíë=Ü~Ç=Ñ~áäÉÇ
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qÜÉ=ìêçÑäçïãÉíêó=Ç~í~=~åÇ=éçëíîçáÇ=êÉëáÇì~ä=çÑ=íÜÉ==é~íáÉåíë=~í
Ä~ëÉäáåÉ=~åÇ=éçëíJmcjq=~êÉ=äáëíÉÇ=áå=q~ÄäÉ=OK=_çíÜ=ã~äÉë=~åÇ=ÑÉã~äÉë
Ü~Ç=ëáÖåáÑáÅ~åí=áãéêçîÉãÉåíë=áå=nã~ñ=~åÇ=îçáÇÉÇ=îçäìãÉ=~ÑíÉê=mcjqK
The Symptomatology of Lower Urinary Tract Symptoms in Patients Undergoing Biofeedback PFMT
Frequency
Urgency
Urge incontinence
Nocturia
Small caliber urine
Residual urine
Straining to void
Table 2.
obpriqp
Men (n=31)
Women (n=37)
Total (n=68)
21
7
2
17
18
15
4
32
19
7
12
8
18
7
53 (78.0%)
26 (38.2%)
9 (13.2%)
29 (42.6%)
26 (38.2%)
33 (48.5%)
11 (16.2%)
The Uroflometry Data at Baseline and 3 Months after Biofeedback PFMT in Patients with OAB and Voiding Dysfunction
Total (n=68)
Men (n= 31)
Women (n=37)
baseline
Post-PFMT
P value
baseline
Post-PFMT
P value
baseline
Post-PFMT
P value
Qmax (mL/s)
Voided volume (mL)
14 ± 7.5
19.5 ± 9.7
0.000
10.5 ± 4.3
14.1 ± 4.7
0.000
17 ± 8.3
24 ± 10.5
0.000
256 ± 135
374 ± 144
0.000
243 ± 148
375 ± 153
0.000
268 ± 124
373 ± 54.9
0.000
PVR (mL)
61 ± 70
41.3 ± 49.2
0.037
70 ± 79.6
44.7± 42.1
0.467
53.3 ± 60.7
38.5 ± 54.9
0.072
Table 3. The Uroflometry Data at Baseline and 3 Months after Biofeedback PFMT in Patients with OAB and Voiding Dysfunction
OAB (n=26)
V.D. (n= 42)
baseline
Post-PFMT
P value
baseline
Post-PFMT
P value
Qmax (mL/s)
Voided volume (mL)
PVR (mL)
14.4 ± 7.4
18.4 ± 9.7
0.013
13.8 ± 7.6
20.2 ± 9.7
0.000
229 ± 125
332 ± 132
0.002
273 ± 139
400 ± 146
0.000
58.1 ± 75.5
39.4 ± 45.7
0.220
62.6 ± 67.1
42.4 ± 51.7
0.266
V.D.: voiding dysfunction
NQ
Original article
Table 4. Changes of Uroflometry Data between Baseline and 3 Months in Patients with Successful and Failed Results after Biofeedback PFMT
Qmax (mL/s)
Voided volume (mL)
PVR (mL)
Successful PFMT (n=52)
Failed PFMT (n=16)
P value
7.5 ± 7.6
150 ± 122
-16.8 ± 75.1
-1.1 ± 4.7
12.9 ± 141
-28.8 ± 80.7
0.000
0.000
0.585
(A)
25 mL/s
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0 mL/s
(B)
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0 mL/s
obcbobk`bp
Fig. 1. Uroflowmetry data in a girl with
voiding dysfunction at baseline
and after PFMT. The staccato
flow patter at baseline (A) became a normal bell shape (B) after PFMT. Qmax at baseline and
after PFMT were similar.
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