Abstract
Introduction and Background: The purpose of this case report was to describe the examination, evaluation, and intervention provided to address pelvic floor dysfunction and urinary incontinence in a typically developing child.
Study Design: Case report.
Case Description: The participant was a 5-year 5-month-old girl who was referred to physical therapy due to concerns related to urinary incontinence. At the onset of the case, the participant had been partially toilet-trained for approximately 1 year without achieving full bladder control. Daily incontinence and nightly enuresis were reported. Examination revealed signs and symptoms consistent with pelvic floor dysfunction. Interventions included use of biofeedback to strengthen the pelvic floor musculature and patient/family instruction. The participant was seen for 4 physical therapy sessions over a 2-month period.
Outcome: The participant did not report any episodes of daytime incontinence in the 2 weeks preceding the final physical therapy visit. The participant also no longer reported enuresis and was able to wake at night to urinate if needed (nocturia was reported on 2/7 nights). The participant further demonstrated the ability to perform pelvic floor contractions to counteract detrusor activity in order to prevent urinary leakage until she was able to reach a toilet to void.
Discussion: The participant in this case appeared to respond well to biofeedback-assisted pelvic floor muscle training. Although commonly used to address incontinence in adults, physical therapy also may be an effective, noninvasive intervention option for children who are experiencing urinary incontinence.