Spire Leeds Hospital is the first hospital in the region to offer biofeedback therapy for children with bladder control problems.
The simple and safe treatment is key to treating various incontinence issues in school age children, and its young patients are already experiencing the benefits. The treatment uses interactive video games. But these are no ordinary video games. The child controls the computer not with their hands but by flexing and relaxing pelvic muscles that control the bladder. The games scores link to the patient’s ability to contract and relax these muscles which can help the child to better control their bladder.
Urinary incontinence is a common problem among children. Daytime wetting affects one in 75 children aged three and above and by the age of seven approximately 3% of girls and 2% of boys experience functional daytime wetting at least once a week.*
Biofeedback Therapy can help patients with a variety of bladder problems, such as those who do not fully empty their bladder, suffer from frequent urinary tract infections, strain to pass urine, regularly experience a sudden urge to urinate, and those who have not responded to other forms of treatment.
Consultant paediatric urologist at Spire Leeds Hospital, Mr Ram Subramaniam, said it’s a common problem amongst young children. “As children learn that they can ‘hold back’ urine by keeping the bladder’s sphincter muscle tight, this learned behavior makes it more difficult to fully relax that muscle when it’s time to urinate. As a result, the child’s bladder may not empty completely, setting the stage for urinary infection and incontinence.”
The treatment involves retraining the pelvic floor muscles that control urinary flow. It is a training technique that uses electrodes to help children identify and control their pelvic muscles.
“It can be a distressing time for a child. Yet one which can usually? be easily treated,” said Mr. Subramaniam. “We try to make it fun for the child as the treatment is connected to an interactive video game. It offers a variety of games, from spaceship games to fairy games. It’s called Biofeedback because it allows patients to adjust their behavior based on the feedback they get from the computer screen and sophisticated software. This helps them to retrain the muscles to better control their bladder.”
Twelve-year-old Beth, who lives in Bradford, recently completed a course of Biofeedback Therapy treatment at Spire Leeds Hospital. Beth has suffered from urinary incontinence for many years. Her mum, Natalie, had taken her daughter to see various doctors and tried medications that had not worked. She said “We first noticed it when she was about six. Beth started having accidents where she could not hold it and it had gradually worsened over the years. It was not such a problem when she was younger but she has now reached an age where it is embarrassing for her. We were becoming desperate. Then Dr Subramaniam told us about a new treatment coming to Leeds called Biofeedback Therapy and we decided to try it.”
Beth has now completed six weekly treatments. After the third session she started to see an improvement. Mum, Natalie, said, “It has helped her to control her bladder, it has taught her how to squeeze her muscles and hold it for longer until she can get to the toilet. it’s non-invasive and not painful. It has given her something to build on and she will continue to practice. The treatment has given us hope.”
Beth said, “Alison the nurse is fantastic. She makes it fun and makes me laugh so I do not feel embarrassed at all. The treatment has helped my problem and I feel better about it when I am at school because I now know how to squeeze my muscles and hold it for longer.”
Following an assessment by Mr. Subramaniam, patients usually attend around five to six training sessions with a paediatric nurse and are fully clothed throughout. EMG sensors are placed on the patient’s abdomen and bottom. The signals, which pick up muscle activity are recorded and displayed on the screen.
“Parents are key as coaches at home as the child needs to continue the exercises, said Spire paediatric sister Alison Munro.” In most cases the basic techniques can be learned in the training sessions and are then practiced until they become routine.
Mr. Subramaniam said motivated children of school age are the most suitable patients for Biofeedback Therapy. The treatment may be covered by private medical insurance, although patients are advised to check with their insurers for any individual exclusions. Patients also have the option to fund their own treatment.