Giggle Incontinence (Enuresis Risoria): Causes of Urinating When Laughing

While you may be aware of laughter’s contribution to stress urinary incontinence, less is known about the condition “giggle incontinence”, which is distinct from stress incontinence and mainly affects children. In particular young girls. 

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 medical condition that causes urine leakage 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.  

You can find a more detailed breakdown of stress incontinence here.  

“Giggle incontinence” refers to bladder leakage provoked by laughter – but not by sneezing, coughing or straining, making it distinct from stress incontinence. Urine leakage usually occurs in large amounts when caused by giggle incontinence, 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. This specific interaction is the key distinction between general stress incontinence and giggle incontinence (enuresis risoria). 

Diagnosing urinary health conditions can be difficult as there are several distinct types of incontinence, and several will present similar symptoms. It is possible that some symptoms of daytime leaking may be attributed to giggle incontinence, but those symptoms might have an entirely separate cause. This is why it’s so important to seek specialist medical advice when experiencing incontinence.  

Get advice on how to talk to your doctor about incontinence in our dedicated article. 

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

• urinary tract infection 

• constipation  

• consuming caffeinated drinks  

A GP might ask you to keep a bladder diary to check for the frequency and volume of urination, and to 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 which would suggest stress incontinence). 

You can start keeping a bladder diary even before your doctor recommends this, so that you can arrive at your first appointments with helpful details about your symptoms that can help speed up diagnosis and identification of your specific condition. 

Giggle incontinence in adults is quite rare.  

Giggle incontinence is much more common in children, particularly girls and those aged between 7 and 14. The severity of the condition will vary according to several factors, with some children experiencing only partial emptying of the bladder or small urine leaks. For some however, urinating when laughing can cause the bladder to empty completely. 

The condition usually improves with age, although cases can continue into adulthood. 

The cause of giggle incontinence is currently unknown, however there are several working theories. 

• Some researchers think it is caused by incorrect voiding, which is when the two sets of bladder muscles function incorrectly. 

• Others suspect that giggle incontinence may be due to incomplete or underdeveloped muscles at the base of the bladder, which would otherwise help to maintain bladder control.  

• Another current theory is that urinating when laughing is 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 both children and adults. Unfortunately, there are no giggle incontinence medications.  

As a parent, there are steps you can take to make things easier for your child, which can help them to manage incontinence when laughing:  
  
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 or socialising. 
  
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 can aggravate the bladder. These include caffeine, hot chocolate and fizzy drinks. Milk should also be consumed in moderation. Learn more about how diet affects incontinence in our dedicate article. 

Supporting your child with giggle incontinence involves more than just practical steps. Open communication is essential. Encourage your child to express their feelings about their condition and reassure them. Ensure that you educate yourself and your child about giggle incontinence to help demystify it and reduce any feelings of shame or embarrassment. Establish a routine and consider working with teachers to create a supportive environment at school. 
  
Alongside this, speak to your child’s doctor for more specific advice and assistance.  

In certain cases a doctor may recommend a treatment called “biofeedback”, which helps to increase a child’s awareness of their urinary muscles, helping to strengthen and develop them. 

Additionally, pelvic floor therapy guided by a specialist can offer targeted exercises to improve bladder control. In some cases, cognitive-behavioural therapy (CBT) might be recommended to address any anxiety or emotional distress associated with the condition, helping children develop coping strategies. It's important to consult healthcare professionals to tailor interventions suited to the individual's needs. 

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

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