As Samantha watched her 11-year-old daughter, Amy, shove a pair of urine-soaked jeans into the washer, she knew there was a problem. Amy had suffered a bout of “giggle incontinence," a condition where children and young adults leak urine when they giggle or laugh. Some affected youngsters leak urine at the least giggle, while others don't leak unless they laugh hard.

As children, both Samantha and her sister occasionally suffered from giggle incontinence, which can range from mild urine leakage to a complete emptying of the bladder. Apparently Samantha's mother had, too. Now Amy has the same problem.

What Causes Giggle Incontinence?
Physicians have not pinpointed the exact cause of giggle incontinence, which affects about 7% of girls and 3% of boys in the U.S. Most children and young adults who suffer from this condition don't have any physical abnormalities. Research indicates that this condition may be genetically-linked and can be passed down from parents to children.

It's most likely that giggle incontinence happens because laughter can cause a loss of muscle tone in the pelvic region. Another possible cause is that some people “hold" their urine too long, causing an overfull bladder. Constipation may be a further contributing cause, since straining to have a bowel movement puts pressure on the bladder. Most affected youngsters stop leaking urine by the time they hit their teens, probably because of maturation of the brain and bladder.

Treatment for Giggle Incontinence
The treatment for urinary incontinence in children and young adults is similar to that for adults. Experts suggest the following treatments:

Practice Proper Voiding: Children past age 5 should void 4 to 7 times a day. Bladder training and following a voiding schedule may help reduce incontinence. In addition, teaching affected children to fully empty their bladders each time is useful.

Avoid Constipation: Those affected often experience relief from giggle incontinence when they add more fiber to their diets, and experience less constipation.

Use Medication: Certain drugs have been proven effective for reducing symptoms of giggle incontinence. However, parents need to take into consideration the side-effects of these medications, which include dry mouth and changes in mood, sleep, or appetite.

Practice Kegels: Studies have shown that people affected by giggle incontinence can reduce leakage by doing Kegels and strengthening their pelvic floor muscles.

Camouflage: Those embarrassed to go out in public because of leakage can reduce the visibility of symptoms by wearing dark clothing and using incontinence pads.

Behavior modification has also been studied as a form of therapy for giggle incontinence. One study, published in a 1995 issue of the British Journal of Urology, indicated that mild shock therapy was an effective approach. Children gave themselves a very mild shock on the back of their hand when they started the laugh. The shock served as a “noxious response" to giggle incontinence. Within a year, all the children in the study showed a 90% decrease in symptoms. Strange but true.

The good news is that giggle incontinence is not a “forever" condition for the majority of people affected, and parents can use the above suggestions to help their children reduce or completely eliminate symptoms.