To explore the clinical features, diagnosis and managements of pelvic floor dysfunction (PFD) in children.

From January 2015 to December 2019, retrospective review was conducted for clinical data of 145 BFD children.Age, gender, clinical symptoms, disease course, surgical history, medication details, results of clinical examinations (pelvic floor surface electromyography, anorectal manometry & urodynamics) and treatment protocols were recorded.

There were simple constipation (n=35, 24.1%) and dirty stool incontinence (n=18, 12.4%). Among simple urination disorder (n=41, 28.3%), there were urinary urgency (n=6), frequent urination (n=11), daytime urinary incontinence (n=6), nocturnal enuresis (n=11), daytime & nocturnal incontinence (n=3) and dysuria (n=5); 46 cases of constipation plus urinary incontinence (n=46), constipation plus dysuria (n=5) and discomfort in lower abdomen (n=4). Based upon pelvic floor surface electromyography, anorectal manometry and urodynamics, they were divided into five types of Ⅰ (high-tension, n=24), Ⅱ (low-tension, n=23), Ⅲ (synergy, n=29), Ⅳ (abnormal defecation motility, n=32) and Ⅴ (paraesthesia, n=37). Targeted pelvic floor biofeedback training and sacral nerve electrical stimulation were performed accordingly.Type Ⅰ exercise was intended for reducing muscle tension and symptom score showed effectiveness (n=16, 66.7%); type Ⅱ for strengthening muscle tension with effectiveness (n=21, 91.3%); type Ⅲ for improving coordination with effectiveness (n=16, 55.2%); type Ⅳ receiving no biofeedback treatment; type Ⅴ for improving rectal mucosal sensitivity with effectiveness (n=28, 75.7%); The difference in effective rate was statistically significant among different groups (χ²=8.845, P=0.031). Children of types Ⅰ, Ⅲ & Ⅴ were followed up for 1 year with excellent outcomes.Three cases relapsed with a recurrence rate of 5%.In type Ⅱ, peak effect occurred mostly at Month 3 post-treatment; symptoms gradually recurred at Months 3-6 post-treatment and some cases recurred at Month 6 post-treatment and most symptoms recurred at Year 1 post-treatment.Except for repeated symptoms, none of them reported any other adverse reaction.

Pediatric PFD may be divided into five types based upon clinical symptoms and objective examinations.Combined application of pelvic floor biofeedback training and sacral nerve electrical stimulation is an effective treatment.Individualized treatment is based upon clinical classification.

Pelvic Floor Dysfunction; Pelvic Floor Disorders; Colonic Diseases, Functional; Biofeedback Therapy; Sacral Nerve Stimulation; Anorectal Manometry; Child