"Giggle Incontinence" No Laughing Matter for Kids

Just as in adults, children can experience urinary incontinence and pelvic floor dysfunction, yet the condition is often under-diagnosed or not readily recognized. In some kids, a single laugh can cause urinary leakage and great anxiety.  

“Occasional daytime wetting in younger children and children who are still toilet training is a normal part of development,” explains Robert Mevorach, M.D., director of pediatric urology at Chesapeake Urology For Kids. “However, if urine leakage begins to interfere with a child's social development, academic progress in school, or sense of well-being, an evaluation for pelvic floor muscle dysfunction or other causes of incontinence by a pediatric urologist is important.”



Parents may notice symptoms of urinary incontinence and/or pelvic floor muscle dysfunction in their child:

  • The child leaks urine when they laugh (giggle incontinence), cough or exercise.
  • The child may experience frequent urination and frequent urge to urinate, sometimes caused by a urinary tract infection (UTI).
  • Daytime wetting and bed wetting may go hand-in-hand for some children.


  • Constipation - In about 70% of cases, children experiencing urinary incontinence are constipated. A full bowel can put added pressure on the bladder, causing leakage of urine. Relieving the constipation will often alleviate incontinence.
  • A bladder or urinary tract infection (UTI).
  • “Holding it in” – a child may hold their urine during an entire school day for fear of using a public bathroom, leading to urinary voiding issues, accidents and urine leakage.
  • Younger children may hold their urine until the last second when they are distracted by play or activity, resulting in an “accident.”



At Chesapeake Urology For Kids, Dr. Robert Mevorach and his team of pediatric urology specialists work to uncover the underlying causes of a child’s urinary incontinence. For children who have been toilet trained for some time who continue to experience incontinence, an initial evaluation may also be followed by a referral to a pelvic health physical therapist. In fact, physical therapy is often a first line treatment for children experiencing urinary incontinence symptoms.



Chesapeake Urology For Kids partners with pelvic health physical therapists that are specially trained in pediatric pelvic floor dysfunction. “By working with a physical therapist who specializes in pediatric pelvic floor muscles conditions, we find that children experience a great deal of success in controlling and overcoming urinary issues,” adds Dr. Mevorach.

A pelvic health physical therapist will look at the muscles of the abdomen, legs, and back as well as the child's diet, sleep patterns, exercise and assess any behavioral issues that may be contributing to the problem.

Treatment is one-on-one and is focused on being fun as well as educational for the child and the parents. “We use tools such as animated biofeedback where kids receive a sticker on their bottom that can transmit images of their pelvic floor muscle contractions through animated games on a computer,” explains Jodi Berger, MPT, of In Balance Physical Therapy.

“For example, when a child squeezes their sphincter muscles, they make a space shuttle on the computer reach its dock. This way, we get the visual muscle feedback we need to identify problems and the kids are performing pelvic floor muscles exercises while playing fun computer games.”

Pelvic health physical therapists educate kids and parents about exercises that strengthen pelvic floor muscles as well as help develop strategies for overcoming incontinence in school and in social situations through positive reinforcement.

“Research has shown that proper pelvic floor muscle training and biofeedback dramatically improves voiding dysfunction such as urinary incontinence in children,” adds Jodi.  


Learn more about urinary incontinence in kids as well as solutions to daytime wetting and bedwetting in children – visit Chesapeake Urology For Kids - http://forkids.chesapeakeurology.com/ 
or call 410-738-8180.