Classification And Guiding Significance Of Pelvic Floor Dysfunction For Children

Objective To discuss the clinical classification of pelvic floor dysfunction in children and its guiding significance for clinical treatment.Methods The subjects were divided into control group and treatment group.The control group consisted of 25 patients with pelvic floor dysfunction treated by single mode,including 14 males and 11 females,with an average age of 7.0 years.The treatment group enrolled 145 patients of pediatric surgery outpatient department with pelvic floor dysfunction from January 2015 to December 2019,including 68 males and 77 females,aged from 5 to 14 years,All patients in the treatment group received pelvic floor surface electromyography,anorectal manometry or urodynamics examination.Classification was proposed according to the results of examination,and individualized treatment plan was adopted.Clinical features,objective test results,treatment strategies and follow-up results of all patients were analyzed retrospectively.The symptoms of pelvic floor dysfunction at the end of the treating course and in the follow-up period were evaluated respectively,and the evaluation indexes were evaluated by symptom assessment combined with objective examination.The effective rate of the control group,the subtype treatment group and each subtype were calculated respectively,and the chi-square analysis was used to compare different groups.Results The effective rate in the control group was 44.0%.According to the symptoms and objective examination results,children’s pelvic floor dysfunction can be divided into five subtypes: high tension,low tension,dyssynergia,low bowel/urinary motility and paresthesia.According to the classification,targeted pelvic floor biofeedback training and sacral nerve electrical stimulation treatment were conducted.Type I was trained to reduce muscle tone;type II was trained to strengthen muscle tone;type III received improved coordination training;type V was trained to improve the sensitivity of rectal or bladder.The overall effective rate in treatment group was 71.7%,including 66.7% for type I,91.3% for type II,55.2% for type III,and 75.7% for type V.The overall effective rate of classification treatment and the effective rate of each subgroup were compared with the control group respectively.The overall effective rate of classification treatment was higher than that of the control group(P=0.002).The effectiveness of type II and type V was significantly better than that of the control group,while the effective rate of type I and type III had no statistical significance compared with the control group.Conclusion Pelvic floor dysfunction in children can be divided into five types.According to the subtype to take targeted biofeedback treatment measures can obtain satisfactory treatment results.