MOCZENIE WYWOŁANE ŚMIECHEM. PROBLEM ŚMIECHU WART CZY SCHORZENIE WYMAGAJACE LECZENIA?

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]