Laughter and giggle incontinence: why some children pee while laughing

While many are aware of laughter’s contribution to stress urinary incontinence, less is known about the condition “giggle incontinence”, which mainly affects children.

Although the symptoms of laughter-induced stress incontinence and giggle incontinence are alike, the causes are thought to be different. Read our guide to help differentiate between the two and the potential causes of urine leakage while laughing.

Stress urinary incontinence describes a condition that causes urine to leak when you laugh, sneeze, cough, or perform any other activities that put pressure (that is, ‘physical stress’) on the bladder. It’s the most common type of urinary incontinence among women, affecting around 15%.

There are a number of causes of stress urinary incontinence. The condition occurs when the parts of the urinary tract responsible for maintaining control (‘continence’) aren’t working properly. In most individuals, this is due to weakened muscles of the pelvic floor or urethral sphincter. Find out more about stress incontinence here. 

“Giggle incontinence” refers to bladder leakage provoked by  laughter – but not by sneezing, coughing or straining, making it distinct from stress. Leakage usually occurs in large amounts, and often results in the complete emptying of the bladder. With giggle incontinence, laughter causes the detrusor muscle (found in the wall of the bladder) to contract when it shouldn’t, resulting in involuntary urination. 

It is easy to assume that symptoms of daytime leaking are due to giggle incontinence, but the same symptoms might have another cause entirely. 

First a GP or urologist should rule out other common causes of leakage, such as:

• urinary tract infection
• constipation 
• consuming caffeinated drinks. 

It’s also important to make sure that the bladder is completely empty after each trip to the bathroom. A GP might ask for a bladder diary to check for the frequency and volume of urination, check whether there’s ever the sensation of urgency (a feeling that you need to pee desperately) or any other cause of incontinence (such as sneezing, coughing or straining).

Giggle incontinence is typically seen in children, and is more common in girls than in boys, particularly those aged between 7 and 14. The severity of the condition depends on the individual, with some children experiencing only a partial emptying of the bladder, while others’ empty completely. 

Giggle incontinence usually improves with age, although some cases do continue into adulthood.

Doctors don’t yet know what causes giggle incontinence. There are several working theories, however.

• Some think it is caused by incorrect voiding, when the two sets of bladder muscles function incorrectly.
• Others think that giggle incontinence may be due to incompletely developed muscles at the base of the bladder, which would otherwise serve to maintain bladder control. 
• Another theory is that it’s caused by an imbalance in the control of the bladder by the nervous system. 

Research into the various potential causes is ongoing.

Most children tend to grow out of giggle incontinence. In the meantime, however, loss of bladder control can be very embarrassing and distressing for a child. As a parent, there are steps you can take to make things easier for your child, and help them to manage an unstable bladder:
 
1. Ease their anxiety. Help reduce your child’s concerns by reassuring them that accidents aren’t their fault.
 
2. Pre-empt accidents. Encourage your child to go to the toilet before taking part in activities which might induce giggle incontinence, such as sporting events and seeing friends.
 
3. Manage fluid intake. While it’s important for your child to drink at least 6-8 glasses of water every day, certain beverages should be avoided as they aggravate the bladder. These include caffeine, hot chocolate and fizzy drinks. Milk should also be consumed  in moderation. 
 
If these steps aren’t effective, speak to your child’s doctor. They may recommend a non-drug treatment called “biofeedback”, which helps to increase a child’s awareness of their urinary muscles, and teaches them to strengthen and develop the right ones.

Understanding the link between laughing and incontinence is the first step towards managing either your or your child’s condition. To learn about other types of urinary incontinence, visit our articles on urgency and frequency for more information. Or if you’re suffering from bladder leakage, shop our range for products to protect from mild to moderate incontinence.

<< Back to articles