Giggle Incontinence

What is Giggle Incontinence?

Giggle Incontinence is the involuntary, unstoppable, complete bladder emptying, during or immediately after laughing or giggling.

It is caused by the muscle of the bladder (detrusor muscle) contracting in response to laughter. The mechanism that triggers this is not fully understood but may be related to ‘cataplexy’, which is a sudden loss of muscle tone while a person is awake leading a loss of voluntary muscle control that is often triggered by sudden, strong emotions such as; laughter, fear, anger, stress, or excitement.

This contraction of the bladder muscle can result in partial or complete emptying of the bladder and therefore can cause large volumes of wee to be passed, causing wetting.

Whom does Giggle Incontinence affect?

Giggle Incontinence affects children over 5 years old but is most common in early or mid-puberty.

Giggle Incontinence is more common in girls, with a strong female family history of this condition than boys.

Giggle Incontinence tends to improve with age, with fewer episodes of wetting during teenage years but can persist into adulthood.

How is Giggle Incontinence diagnosed?

Giggle Incontinence is only diagnosed after a full continence assessment is performed in a specialist service, after ruling out any other conditions that may be causing wetting.

The features that should be present are:

  • A big wee passed into the underwear only when laughing, but no other urinary incontinence at any other time.
  • Able to stay dry when cough or take part in physical activities.
  • Passing wee 6-8 times a day
  • No urinary tract infection
  • No urgency to get to the toilet and able to hold a wee if there is no toilet available.
  • No Lower Urinary Tract Dysfunction
  • No constipation
  • Drinking age appropriate fluid volumes throughout the day

How is Giggle Incontinence treated?

Firstly, it is important to reassure the child that wetting is not their fault and instead is due to a completely involuntary bladder contraction.

There is no specific medication or cure for Giggle Incontinence, and almost all children will become completely dry by adolescence.

However, after ruling out any other conditions that may be responsible for the wetting and following practical advice outlined below for 3 months, the child GP’s can refer to the bladder and bowel specialist service.

The Specialist Bladder and Bowel Service will carry out a full continence assessment to explore alternate diagnosis ruling out Constipation, Overactivity of the Bladder, Vaginal Pooling, Dysfunctional Voiding.

If wetting continues to be an issue to the child and the family a trial of medication that works on the bladder wall to relax it (anticholinergic) could be considered.

If wetting has not resolved then a referral to secondary care can be made by the bladder and bowl specialist service.

It has been recognised that the medication traditionally used to treat Attention Deficit Hyperactivity Disorder (ADHD) (Methylphenidate / Ritalin) can be successful in improving Giggle Incontinence in some children and therefore could be considered

Practical advice for good bladder health

Good fluid intake – ideally should have six to eight drinks, evenly spaced out throughout the day, with the last drink no later than one and a half hours before sleeping at night.

The suggested daily intake of fluid for children and young people are as follows:

      Preschool                    1200ml

Infant school               1500ml

Junior school               1800ml

Secondary school       2500ml (female)  – 3200ml (male)

Avoid drinks which may irritate the bladder such as; citrus drinks, fizzy drinks, caffeinated drinks, hot chocolate, tea and coffee.

Establish good toileting routines. Emptying the bladder 6-8 times each day, with last toilet visit before going to sleep.

Good toileting technique. Practising relaxed voiding, sitting on the toilet with a well-supported bottom (use toilet insert if necessary), feet on a step / stool to ensure that these are higher than hips, with legs slightly parted, while taking time to allow the bladder to empty

Ensure complete emptying of the bladder by rocking back and forth a few times; double voiding (go for a wee, then try to pass another wee before getting off the toilet)

Aim to empty the bladder before any activity that may involve giggling / laughing.

Pelvic floor exercise if the child is able to follow and understand instructions

Ensure open bowels daily or alternate days.

Eat a well-balanced diet, including fibre choices of two portions of fruit and three portions of vegetables a day alongside a variety of wholemeal foods and snacks to avoid constipation.

Keep as active as possible, recommended at least 30 minutes of exercise daily.

Useful Websites

Bladder and Bowel Service

Bensham Hospital

Saltwell Road



This leaflet has been adapted from GNCH