[Biofeedback treatment of giggle incontinence in a teenager]

Abstract

Giggle incontinence is a rare syndrome in which apparently complete voiding occurs specifically during laughing. It needs to be differentiated from stress incontinence and detrusor instability. Reports on the treatment outcome of this disorder are rare.

The aim of the study: To present the effect of biofeedback treatment for giggle incontinence in a 15-year-old girl. A 15-year-old girl is presented with isolated symptoms of giggle incontinence from early childhood with 1-2 episodes per week of complete bladder emptying during laughter. She demonstrated no symptoms of detrusor hyperactivity or stress incontinence. Her urodynamic studies were normal. The child started pelvic floor muscle exercises using biofeedback according to the pediatric protocol of an UROSTYM device. Five hourly sessions were performed to teach the child control of her external urinary sphincter muscles. This was followed by daily home exercises and weekly biofeedback sessions. Improvement was immediate and during 2 months follow-up no incidents of giggle incontinence were observed.

Conclusions: (1) Biofeedback can be used in children with giggle incontinence to strengthen their pelvic floor muscles and allow them to remain continent during an uncontrolled detrusor contraction provoked by laughing. (2) Biofeedback enables children to visualize the pelvic floor muscles during exercises helping them to attain better control of their function. (3) Pelvic muscle exercises with biofeedback technique are a promising additional mode of treatment for children with voiding disorders.