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Introduction. Dysfunctional voiding is a frequent condition in children associated with symptoms of incontinence. The aim of this study was to present the efficacy of biofeedback treatment on the resolution of clinical symptoms in a large cohort of children with urodynamically confirmed dysfunctional voiding. Material and methods. 81 children (75 girls and 6 boys) aged 6-18 years (mean: 10.32 ±3.17 yrs.) with a dysfunctional voiding pattern are presented. 74/81 (92.6%) of children were unresponsive to standard urotherapy and prior pharmacotherapy. Symptoms of bladder dysfunction were evaluated by questionnaire, bladder diary and an urodynamic study according to definitions and standards set by ICCS. The biofeedback training was planned for 2 months. Each session consisted of about 30 repeats of 5 s contraction and 30 s relaxation of pelvic floor muscles and external urethral sphincter. Biofeedback was performed together with standard urotherapy. Results. 67 (82.72%) of the 81 children declared wetting during the day and 41 (50, 62%) - wetting during the night. 32/81 (39.5 %) children had increased voiding frequency and 43 (53.08%) had decreased bladder capacity. Following 2 months of biofeedback therapy daytime incontinence resolved in 34/67 (50.7%) children and nighttime incontinence in 22/41 (53.65%). A further 40,3% declared partial improvement in daytime and 26.7% in nighttime wetting. Conclusions. Biofeedback treatment is an effective therapeutic option for children with dysfunctional voiding. Pelvic floor therapy with biofeedback should be offered to children with dysfunctional voiding resistant to standard urotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Incontinence during laughter is a symptom of different micturition disorders. It is seen in patients with overactive bladders, stress incontinence or as an isolated symptom in giggle incontinence. Aim of the study: To present the different micturition disorders associated with incontinence caused by laughter Material and methods: Case reports of 3 pathogenetically different cases of incontinence associated with laughter. Results: Case 1 - a 9-year-old girl with incontinence caused by laughter with a history of urgency and frequency. Her bladder diary showed frequent, low volume micturitions. Uroflowmetry revealed detrusor contractions during filling. An overactive bladder was diagnosed. Following 6 months of anticholinergic treatment all symptoms resolved. Case 2 - a 14-year-old girl with incontinence following laughter or exercise. Urgency and frequency developed after intense horse riding. Her micturition diary showed frequent and low volume micturitions. A urodynamic study revealed dysfunctional voiding without signs of an overactive bladder. Stress incontinence was diagnosed Successful biofeedback treatment was introduced together with oxybutynin. Case 3 - a 15-year-old teenager complained of episodes of complete bladder emptying during laughter with no other symptoms of abnormal bladder function. Both ultrasound and uroflow studies were normal. Giggle incontinence was diagnosed and treated successfully with biofeedback reinforcement of pelvic muscles. Conclusions: 1. Incontinence due to laughter is a symptom of a variety of micturition disorders. 2. A thorough medical history, bladder diary and uroflow study enable rapid diagnosis. 3. Treatment should be aimed at correction of the underlying problem. [ABSTRACT FROM AUTHOR]