Ask Dr. Hunter Wessells : Incontinence in Young Adults

Q: I have a teenage daughter who has occasional trouble with incontinence. She is very healthy, and active in sports. About twice a month she seems to lose control of her bladder when laughing. I brought her to a specialist six months ago, who found nothing physically wrong with her. He suggested the leakage might occur when her bowels were abnormally full (which was indicated by X-rays). She's since been taking fiber in the evening to minimize this issue. Yet the incontinence persists. Is this at all normal? What else should we be looking at?
— Mary, Minneapolis
Dr. Hunter Wessells - Incontinence Center A:  Your daughter appears to be suffering from a condition called giggle incontinence. You describe it well, namely, the insuppressible urge to urinate associated with laughter. This has been described in several reports in the medical literature. Although it is not associated with any significant underlying medical disorders, incontinence of even small amounts can be quite distressing to the individual. Thus, it would be difficult to consider this to be a "normal" condition. The mechanism of giggle incontinence is not entirely understood, but laughter may trigger a bladder contraction, which would lead to the urinary leakage. In the absence of incontinence in other situations, it is not typically necessary to perform extensive testing in such patients.

The long-term natural history of this condition is not well described, but as with other types of incontinence occurring in childhood and adolescence, young people with further development and maturation will often outgrow it. There are no specific treatments for giggle incontinence, although some researchers have advocated the use of antispasm medicines, based on the theory that the incontinence is caused by a triggered bladder spasm. However, this may lead to overtreatment and side effects associated with typical antispasmodic drugs, such as mouth dryness and constipation. Kegel exercises could be helpful in this situation, since this exercise (namely tightening the pelvic floor muscles) could interrupt a reflex bladder contraction.
Last Updated: 05/21/2007
Incontinence expert Dr. Hunter Wessells answers your frequently asked questions on incontinence causes, symptoms, diagnosis, treatment, medications, management, and resources. Dr. Wessells is the chief of urology at Seattle’s Harborview Medical Center.

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