The aim of the study was to investigate the effectiveness of physiotherapy in children with voiding disorders and malformation of the urinary tract refractory to medication. Also, establish the minimum number of sessions required to observe the perception of improvement.

It is a quantitative, descriptive, observational, and retrospective study based on the analysis of medical charts of patients treated at the Children's Pelvic Physiotherapy Outpatient Clinic of a University Hospital. The effectiveness of the treatment was based on the percentage (%) of improvement reported by the patient and/or guardian during or at the end of the treatment, with the data collected during the sessions being attached to the evolutions and, in turn, to the medical record. After analyzing the data, it was considered worsening when the urinary symptoms persisted at the same intensity or worsened, small improvement when the patient presented between 0-39% of improvement in symptoms, moderate improvement when the patient presented 40-79% of improvement in symptoms. improvement of symptoms and significant and/or complete improvement when the patient presented 80-100%.

Twenty-three medical records were included, with 60.86% of the sample consisting of male patients, with a mean age of 5.95 for both sexes (±3.22).

Evaluating the malformations and clinical variables, it was found that the most common malformation among the studied sample was the posterior urethral valve (17.39%), followed by pyelocaliceal dilation (13.04%). As the main complication of the malformation, the occurrence of hydronephrosis was observed in 56.52% of the sample. Regarding the clinical characteristics, the most frequently reported voiding symptoms were urinary tract infection (73.91%), urinary incontinence (60.85%), and voiding urgency (47.82%). The vast majority (91.30%) of these signs and symptoms were not associated with the patient's emotional state. Furthermore, complaints and symptoms of constipation were found in 30.43% of the patients in the sample. As for the physical therapy intervention performed, it was observed that all patients received initial instructions and parasacral electrostimulation with parameters of 10 Hz frequency, 700 us of pulse width, and varying intensity, according to the subject's tolerance, for a period of 30 minutes, 1 time a week. Home exercises were also a frequent intervention, present in 56.52% of patients. Other treatments, such as kinesiotherapy, biofeedback, bladder emptying maneuvers, abdominal exercises, and programmed urination were also interventions present in the medical records, but to a lesser extent. Finally, analyzing the characterization of the number of sessions, the onset of improvement reported and the percentage of improvement reported, it can be observed that most patients (55.52%) underwent 6 to 10 intervention sessions, with the onset of improvement reported between the first 5 sessions (65.21%), with a report of significant and/or total improvement in 65.21% of the analyzed sample.

We concluded that Pelvic Physiotherapy is an effective alternative for the treatment of voiding disorders in children diagnosed with urinary tract malformations, in which the previous pharmacological treatment was not successful, with the majority having, significant and/or complete improvement in voiding symptoms (80-100% reported improvement) for 65.21% of the population studied, with rapid responses to treatment (1st to 5th session), also in 65.21% of the sample.

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Continence 2S2 (2022) 100444
DOI: 10.1016/j.cont.2022.100444