Vesico-sphincteric dyssynergy (VSD) represents a complex urological dysfunction characterized by the lack of coordination between the bladder and urethra during the micturition process. This condition involves the simultaneous contraction of muscles with opposing functions, resulting in ineffective voiding. The primary objective of our study was to evaluate the effectiveness of perineal rehabilitation with biofeedback in addressing vesico-sphincteric dyssynergy.

We conducted a prospective study involving 32 patients spanning various age groups, including children, adolescents, and adults, who sought treatment at the Department of Physical Medicine and Functional Rehabilitation at Ibn Rochd University Hospital in Casablanca over a period of 12 months. All patients presenting with symptoms indicative of VSD on uroflowmetry underwent a structured program of perineal rehabilitation with biofeedback, consisting of an average of 12 sessions. Follow-up uroflowmetry assessments were conducted post-intervention to evaluate treatment outcomes.

The mean age of the study participants was 29 years, with a wide age range from 8 to 59 years, and a male-to-female sex ratio of 0.5. Clinically, patients exhibited dysuria and reported a sensation of incomplete bladder emptying, with a notable subset experiencing recurrent urinary tract infections. Initial uroflowmetry assessments revealed diminished flow rates in 79% of cases, along with evidence of VSD on electromyography (EMG) recordings and significant post-void residual urine in 69% of cases. Following completion of the perineal rehabilitation program with biofeedback, improvements in dysuria and resolution of VSD were observed in 77% of cases during the subsequent 3-month follow-up uroflowmetry. However, persistent post-micturition residual urine was noted in 42% of cases, indicating the need for continued management.

Our study investigated the efficacy of perineal rehabilitation with biofeedback in treating vesico-sphincteric dyssynergy (VSD). We observed significant improvements in dysuria and resolution of VSD in a majority of cases following biofeedback therapy. These outcomes highlight the potential of biofeedback as a valuable adjunctive treatment for VSD, enhancing pelvic floor muscle coordination and bladder function. However, some patients experienced persistent post-micturition residual urine, indicating the need for individualized management approaches. Integrating lifestyle modifications alongside biofeedback therapy could further enhance treatment outcomes. Overall, our findings underscore the promising role of biofeedback in managing VSD, though further research is needed to optimize treatment protocols and address residual urine retention.

Biofeedback therapy plays a crucial role in modulating pelvic floor muscle activity during voiding, facilitating relaxation and coordination essential for efficient bladder emptying. Our findings suggest that perineal rehabilitation with biofeedback holds promise as an effective therapeutic intervention for managing VSD, particularly when integrated with lifestyle modifications. However, sustained efforts and periodic follow-up may be required to optimize long-term treatment outcomes and ensure patient satisfaction and quality of life.