Maria Verônica Pires, Jorge Nilton Casotti, Henrique Cunha Carvalho, Carlos José de Lima
Hinman syndrome (HS) represents the severe clinical phenotype of dysfunctional voiding, characterized by functional bladder outlet obstruction in neurologically normal children. This study evaluated the effects of photobiostimulation (PBST) in two pediatric patients using serial urodynamic assessments. Two pediatric patients diagnosed with HS underwent a PBST therapeutic protocol based on light-emitting diodes (LEDs) emitting in the red spectrum (λ = 630 nm). Irradiation was applied over the suprapubic region. Baseline invasive urodynamic assessment (filling cystometry and pressure-flow study) was followed by serial free uroflowmetry during treatment to evaluate bladder emptying, voiding efficiency (VE), and detrusor kinetic parameters. At baseline, both patients exhibited detrusor hypocontractility and reduced emptying efficiency. Following PBST treatment, a reduction in post-void residual (PVR) of 93.6% was observed in patient 1 and 59.6% in patient 2, reflecting gains in VE of 277.4% and 18.7%, respectively. These preliminary findings suggest that PBST may improve bladder emptying in children with HS, as evidenced by increased voiding efficiency and improvements in detrusor kinetic parameters. The functional improvements are biologically plausible considering the known bioenergetic effects of PBST. The present findings support further investigation of suprapubic PBST as a non-invasive adjunctive therapy for pediatric dysfunctional voiding.