{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:30:24Z","timestamp":1787167824716,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["LUTS"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyze the management strategies in the children who had treatment\u2010resistant dysfunctional voiding (DV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 75 children with DV who underwent pelvic floor biofeedback therapy (BF) between 2013 and 2020, 16 patients (14 girls, 87.5%) with a mean age of 9.81\u2009\u00b1\u20092.53\u2009years that showed incomplete clinical response following urotherapy and initial BF sessions were retrospectively reviewed. The demographic and clinical characteristics, DVSS, and uroflowmetry parameters were recorded before and after the initial BF sessions. Subsequent treatments after initial BF and clinical responses of patients were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinical success was observed in one patient by addition of an anticholinergic and in three patients with combination of salvage BF sessions and anticholinergics, whom had predominant overactive bladder (OAB) symptoms. The success rate of TENS alone and in combination with other treatment modalities was 88.8% (8\/9 patients). In addition, salvage BF sessions (range 2 to 3) enabled clinical success in five (50%) of 10 cases as a combination with anticholinergics or TENS. In case of incomplete emptying without OAB, adequate clinical response to Botulinum\u2010A was observed during an average follow\u2010up of 29\u2009months in two boys who did not respond to alpha\u2010blockers, even though one required repeat injection after 10\u2009months. The total clinical success rate was 87.5% (14\/16 patients) after a median follow\u2010up of 24\u2009months. VV\u2010EBC and Qmax increased by a mean of 30.89% and 7.13\u2009mL\/min, respectively, whereas DVSS decreased by a mean of 8.88 points and PVR\u2010EBC decreased by a median of 19.04%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings showed that clinical success in resistant DV was achieved by various combination treatments in the majority of children. However, a small group may still have persistent, bothersome symptoms despite multiple treatment modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/luts.12528","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T08:36:16Z","timestamp":1719304576000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Urotherapy and biofeedback resistant dysfunctional voiding: How to deal with?"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-7942","authenticated-orcid":false,"given":"M. \u0130rfan","family":"D\u00f6nmez","sequence":"first","affiliation":[{"name":"\u0130stanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology \u0130stanbul University  Istanbul 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