**4.2 Goals**

The goals of urotherapy are clearly defined and include normalization of the phase of filling and emptying the bladder, facilitation of normal bowel function and normalization of the dynamics of defecation. The goals of treatment in clinical practice are aimed at reducing urgency and urinary incontinence, nocturnal enuresis, post-void residual urine, high intravesical pressure, PFM activity in the micturition phase, normalization of uroflowmetry curve, cure urinary tract infections and constipation, and reduce the degree of VUR.

#### **4.3 Indications**

Urotherapy is used in functional voiding disorders that are accompanied by an altered phase of bladder filling and emptying, in children in whom satisfactory results have not been achieved with the use of pharmacological therapy, and in children who are just starting therapy.

#### **4.4 Components of urotherapy**

Urotherapy consists of standard urotherapy and specific measures that include neuromodulation, PFM relaxation exercises, biofeedback and intermittent catheterization [4].

#### *4.4.1 Standard urotherapy*

In the literature, we often come across the term "standard urotherapy", which includes education, behavioral modifications, keeping a bladder and bowel diary and regular check-ups [4]. Before starting urotherapy, it is necessary to dedicate a lot of time to educating the child, examining his motivation to carry out the treatment, and eliminating the shame and other effects that urinary incontinence can cause.

#### *4.4.1.1 Education and demystification*

The child should be acquainted with the structure and function of the bladder, external urinary sphincter, colon and anorectum in a way that is appropriate for his age. He also needs to be explained the etiology of his voiding and defecation disorders. It is important to examine the motivation for treatment. If the child is not motivated, the results of the treatment are much worse.

#### *4.4.1.2 Behavioral modifications*

The goal is to improve the control of urination and defecation through changes in the child's behavior. This includes regular voiding and hydration, taking the correct position during urination and defecation, as well as changing the diet. With the application of this initial treatment, a cure can be achieved in about 20% of children [21].
