Giggle incontinence, giggle enuresis or ''enuresis risoria'' is the involuntary release of

urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excretion, excreted from the body through the urethra. Cel ...

in response to giggling or laughter. The

bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

may empty completely or only partially. Giggle incontinence is more common in children than adults, typically appearing at ages 5 to 7, and is most common in girls near the onset of

puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a girl, the testes in a boy. ...

. The condition tends to improve with age, with fewer episodes during the teenage years, but may persist into adulthood. A survey of 99 student nurses indicated that about 25% had experienced such a wetting event during their lifetime, and about 10% were still susceptible in their late teens. Giggle incontinence is a special form of

urge incontinence Overactive bladder (OAB) is a condition where there is a frequent feeling of needing to urinate to a degree that it negatively affects a person's life. The frequent need to urinate may occur during the day, at night, or both. If there is loss ...

, and is not the same as

stress incontinence Stress incontinence, also known as stress urinary incontinence (SUI) or effort incontinence is a form of urinary incontinence. It is due to inadequate closure of the bladder outlet by the urethral sphincter. Pathophysiology It is the loss of sma ...

, which is generally brought on by participating in vigorous sport.

Cause

In voluntary

urination Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, ...

, the bladder's normally relaxed

detrusor muscle The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to stor ...

contracts to squeeze urine from the bladder. One study, of 109 children diagnosed with giggle incontinence at Schneider Children's Hospital in New York, concluded that the cause of giggle incontinence is involuntary contraction of the detrusor muscle induced by laughter. Because the complaint is difficult to reproduce under controlled conditions, its triggering mechanism is not clearly understood, but may be related to

cataplexy Cataplexy is a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions such as laughing, crying, or terror. Cataplexy affects approximately 70% of people who have narcolepsy, and is ...

, a sudden transient episode of loss of

muscle tone In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial muscle contraction, contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sull ...

often triggered by strong emotions.

Social consequences

Episodes of giggle incontinence are embarrassing and socially incapacitating, diminishing the quality of life. Those having the condition learn to adapt by avoiding activities that may bring on laughter (such as being tickled, watching a funny movie or TV program, or reading/listening to funny stories or jokes). Other approaches include limiting fluid intake, trying to remain seated, and concealing leakage by wearing absorbent pads and dark clothing.

Treatment

Favorable response to treatment with the

ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inapp ...

drug

methylphenidate Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, ...

(Ritalin) has been reported, but this treatment option is not acceptable to all patient families. Dr. Lane Robson, of The Children's Clinic in Calgary, Alberta, says "If a child is having a wetting episode once a month, medicating them daily is probably not a good treatment. If it's a daily issue, you may have to make that decision."

References

{{DEFAULTSORT:Giggle Incontinence Urinary incontinence

Cause

Social consequences

Treatment

See also

References