Abstract General Information

Title

GIGGLE INCONTINENCE: A FREQUENT SYMPOTM IN PATIENTS WITH LOWER URINARY TRACT DISFUNCTION

Introduction and objective

The International Children's Continence Society (ICCS) defines giggle incontinence as a rare condition in which significant bladder emptying or leakage occurs during or immediately after laughter, with unchanged bladder function when there is no laughter. However, in clinical practice, it is common to describe laughter-induced incontinence associated with other urinary changes. The objective of this study was to evaluate the prevalence of giggle as a urinary entity that may be associated with other symptoms, as well as the clinical characteristics of patients with this condition.

Method

A cross-sectional study was conducted based on electronic medical record data of patients who initiated treatment for lower urinary tract disorders at the Center between 2007-2023. The presence of giggle was assessed through direct questioning of the patient regarding its presence. Patients were analyzed for the presence of giggle incontinence, as well as urgency, daytime incontinence, polyuria, infrequent urination, potty dance, enuresis, and constipation, with the latter assessed using the ROMA IV criteria. Patients were also analyzed for symptom intensity using the Dysfunction Voiding Scoring System - DVSS.

Results

A total of 664 patients with complete medical records were included to assess the prevalence of giggle. The median age was 8 years (IQR 4-15), with 357 (53.8%) being female. Among them, 118 (17.8%) patients reported the presence of giggle in this sample. Of these, 73 (61.9%) were female. No patient reported giggle as the only symptom.
In comparing urinary symptoms between the group with giggle and the group without giggle, it was observed that patients with giggle had a higher frequency of all the symptoms in question, except for infrequent urination (less than 3 voids per day), with statistically significant differences for urgency, daytime incontinence, polyuria, potty dance, constipation and median DVSS (p<0.01 for all the variables).

Conclusion

The prevalence of giggle in the sample was 17.8%, and in these patients, there was a higher frequency and intensity of urinary symptoms, as well as constipation.