Urotherapy

Standard Urotheraphy

Standard Urotherapy starts with an age-appropriate explanation of bladder and bowel function and dysfunction, to discuss the causes of incontinence.

  • Instructions should be given on appropriate fluid intake and regular voiding during the day.
  • Explanation of the correct toilet posture, teaching a proper press-breathing technique, and advice to use a stepping stool for feet support.
  • Instructions should be given on appropriate fluid intake and regular voiding during the day.
Support and coaching
Timed voiding

Specific Urotheraphy

Specific urotherapy consists of pelvic floor muscle training/ biofeedback and behavioral modification. Pelvic floor training focuses on strengthening and relaxing the supportive muscles of the urinary system.

Biofeedback on the voiding pattern is an essential element of specific urotherapy. It improves the physiological processes of micturition, by teaching children how to urinate with a relaxed pelvic floor and teach them good bladder emptying techniques.

Feedback on correct voiding can be given in the following ways:

  • Real-time flowmetry in which the child is able to observe the flow curve during voiding. Children are taught to recognize when they urinate incorrectly and will keep on trying (through a relaxed posture and softly blowing or whistling to relax the pelvic floor) until they achieve a continuous, bell-shaped curve. Eventually, the child learns to urinate with a relaxed pelvic floor and normal urine volume.
  • Ultrasound can be used to check if the bladder is empty after urination and report this to the child.
  • EMG is strongly dependent on correct placement of the surface electrodes. The feedback from EMG can be used to teach the child to contract and relax the pelvic floor muscles at will.
Lower urinary tract disorders | 3. Master the treatment of LUTD
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