Use of a portable pelvic floor muscle simulator for the correction of urinary incontinence in children

Background. Biofeedback (BF) therapy of the pelvic floor is an established component of urotherapy in pediatric urology and is classified as a method of afferent stimulation. Correction of urinary disorders using BF therapy involves training the pelvic floor muscles, including the rectal and urethral sphincters, through voluntary contractions.

Aim. To establish optimal conditions for use and to evaluate the effectiveness of pelvic floor muscle training for various types of urinary incontinence in children, utilizing the Callibri BeFit portable pediatric biofeedback simulator with an intracavitary sensor.

Materials and methods. The study enrolled 66 children and adolescents aged 5 to 17 years (25 boys and 41 girls) with neurogenic bladder dysfunction, presenting with various types of urinary incontinence: stress incontinence, including laughter incontinence (34 patients), overflow incontinence (11 patients), urge incontinence (12 patients), and nocturnal enuresis (9 patients). Bladder dysfunction was attributed to organic causes (myelodysplasia syndrome) in 28 children and to functional causes in 38 children. All participants underwent clinical and instrumental evaluation, including renal and bladder ultrasound to assess residual urine and comprehensive urodynamic studies. Participants received pelvic floor muscle training using the Callibri BeFit portable pediatric simulator equipped with an intracavitary (rectal) sensor. During the gamified training sessions, objective quality control was performed via the child's mobile device, and a detailed report was generated upon completion of each session.

Results. Improvement was observed in 63 children (94.5%) during the training period. The effects of biofeedback therapy included reduced urine loss as measured by the 24-hour PAD test, decreased urgency, increased bladder capacity, fewer episodes of stress incontinence and enuresis, and, in some cases, the emergence of age-appropriate bladder sensation. According to reports generated on the patients' mobile devices, by the end of the course, the proportion of excellent game results averaged 58%, good results 24%, and the number of points earned increased by 199% compared to initial training.

Conclusions. Pelvic floor muscle training with the Callibri BeFit portable pediatric biofeedback simulator and intracavitary sensor represents an effective non-pharmacological intervention for various types of urinary incontinence and pelvic muscle dyssynergy in children aged 5 years and older without significant mental disorders. This method may be applied selectively or as part of a comprehensive therapeutic regimen, including home-based use. The optimal course duration is 10 training sessions of 20 minutes each, repeated monthly.