Giggle incontinence: a scoping review

• Published in: Pediatric research 2024-06, Vol.95 (7), p.1720-1725
• Main Authors: González-Maldonado, Adrián A., García-Mérida, Manuel
• Format: Article
• Language: English
• Subjects: Adolescent; Bladder; Child; Child, Preschool; Female; Humans; Laughter; Male; Medical personnel; Medicine; Medicine & Public Health; Nervous system; Pediatric Surgery; Pediatrics; Review Article; Urinary Bladder - physiopathology; Urinary incontinence; Urinary Incontinence - diagnosis; Urinary Incontinence - physiopathology; Urinary Incontinence - therapy
• ISSN: 0031-3998; 1530-0447; 1530-0447
• DOI: 10.1038/s41390-024-03065-y

Giggle incontinence (GI) is poorly described, defined, and understood. It is considered a bladder storage disorder in which laughter causes an uncontrollable episode of urinary incontinence that cannot be stopped until the bladder is completely emptied. It has been confused with stress urinary incontinence and overactive bladder. A thorough analysis of 26 articles on the subject of “giggle incontinence” and associated terms was performed, including all articles since the phrase first appeared. To date, 351 GI cases have been reported. It occurs mainly in women (69.5%) at 5 years of age, with a prevalence ranging from 8.4 to 16.2 years (average age of 12.4 years), and some cases have a family history of the disease (13–16.7%). This review discusses the historical background, current understanding, and challenges related to GI. It primarily affects females after the age of 5 years, causing complete bladder emptying during uncontrollable laughter. The exact cause is unknown, but hypotheses suggest involvement of the central nervous system. Diagnosis relies on clinical history, physical tests, and urine frequency evaluation. Management involves urotherapy techniques, biofeedback, and methylphenidate. Understanding GI will aid in developing more effective management techniques. Impact Highlights limited awareness among healthcare professionals about giggle incontinence as a distinct condition, emphasizing the need for standardized diagnostic criteria and assessment tools. Addresses insufficient understanding of the underlying mechanisms and contributing factors, providing valuable insights for better diagnosis and treatment. Emphasizes the importance of patient education and support, calling for improved resources and counseling. Urges further research and evidence-based guidelines to enhance treatment strategies.