Efficacy of Biofeedback Therapy for Giggle Incontinence in Children: How Many Sessions Are Required?

Abstract

Giggle incontinence (GI) is characterized by the sudden and involuntary expulsion of urine coinciding with episodes of laughter. The underlying pathophysiology of this condition remains unclear, and various treatment approaches are employed. The objective of this study is to assess the effectiveness of biofeedback (BF) therapy in treating GI and ascertain the requisite number of therapy sessions needed for efficacy. Medical records of children treated with BF therapy for GI between November 2022 and November 2023 were retrospectively analyzed. The success of treatment was assessed after four and eight sessions, as well as following three maintenance sessions. Treatment outcomes were evaluated using the scoring system recommended by the International Children's Continence Society (ICCS), which categorizes responses into three levels: no response (Score 0), partial response (Score 1), and complete response (Score 2). Thirteen patients were initially diagnosed with GI. Of these, 10 patients were included in the study as three discontinued treatments. The cohort comprised an equal gender distribution with five females (50.0%) and five males (50.0%). The mean age of patients was 8.9 ± 3.3 (range 5-16) years. Two out of ten patients had a history of previous treatment for overactive bladder, while three had received treatment for primary monosymptomatic nocturnal enuresis. Following the completion of all BF sessions, the rate of complete response was observed at 80.0% (n = 8), while the partial response rate accounted for 10.0% (n = 1). Statistical analysis revealed significant differences in response scores after four and eight sessions (p < 0.01) as well as between the results after eight sessions and the completion of maintenance sessions (p < 0.01). BF therapy demonstrates a high success rate in managing GI. Completion of at least eight BF therapy sessions enhances the probability of a successful outcome in the treatment of GI. Additionally, it has been observed that maintenance sessions contribute to the increased efficacy of the treatment.