Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Growth and Dvelopment in Pediatrics

Background: The impact of bed-wetting on children and families can affect a child{u2019}s self-esteem, school achievement, and interpersonal relationship of child and caregivers with increased risk of physical abuse. Purpose: To compare the effect of intra-anal biofeedback and intra-anal electrical stimulation on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). Methods: Ninety children of both sexes aged between 8 to12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group that underwent behavioral therapy and PFMs training, and two study groups (I and II) that underwent the same program in addition to intra-anal biofeedback training and electrical stimulation, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume and a nocturnal enuresis diary was used for documenting wet night episodes before, and after 3 months of treatment. Results: After training, all groups showed a statistically significant improvement in all measured outcomes, with more improvement in favor to the electrical stimulation group II. Conclusions: Electrical stimulation combined with behavioral therapy and PFMs training is more effective in the treatment of PMNE than biofeedback training

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