Giggle Incontinence in an Adolescent Girl: A Case-based Review

Abstract

Giggle incontinence is a form of urinary incontinence triggered by giggling or laughter, with two distinct pathophysiological 
theories proposed for its etiology. Both neurologic receptor imbalance and urologic dysfunction have been suggested as 
potential underlying mechanisms.

We present a case-based review of a 12-year-old girl with refractory giggle incontinence who underwent comprehensive 
evaluation including physical examination, ultrasonography, bladder diary, uroflowmetry, and urodynamic studies. She was 
treated with a combined approach consisting of urotherapy and pelvic floor biofeedback. To enhance and accelerate therapeutic response, low-dose methylphenidate was added. Pharmacologic treatment was administered and tapered over four months, while non-pharmacologic interventions were continued for one year. Follow-up at 18 months demonstrated complete resolution of symptoms.
A comprehensive literature review on giggle incontinence was conducted using PubMed, Scopus, and Google Scholar databases 
for studies published since 2000. Based on current evidence, treatment should be individualized according to the presumed 
underlying mechanism, and successful management requires strong cooperation between the patient, her parents, and the 
healthcare team.
Based on our literature review, treatment depends on the causes, and success requires the patient’s and her parents’ trust and 
cooperation in carrying out the instructions.