Predictive Factors for Complete Treatment Response in Structured Giggle Incontinence Treatment

To compare different treatment options for giggle incontinence (GI) and to identify clinical and demographic factors associated with complete treatment response (CTR) to a structured management protocol.

We evaluated patients treated for GI in our outpatient clinic (2010-2025). Those who failed to achieve CTR and required methylphenidate were divided into two groups: Group 1 received standard urotherapy plus anticholinergics, and Group 2 received standard urotherapy plus biofeedback (BF).

A total of 133 patients were included in the study, Group 1 n = 63 and Group 2 n = 70. Initially, characteristics of patients with CTR with partial and non-responders, multivariate analysis revealed that admission at post-pubertal age, female sex, and a positive family history were significantly associated with complete response for both Group 1&2. However, no significant association was found with body mass index (BMI), Dysfunctional Voiding and Incontinence Symptoms Score (DVISS), constipation or enuresis. As a secondary outcome, response to methylphenidate was assessed. CTR rates were similar at 1 and 3 months, but at 6- and 12-months Group 2 showed significantly higher CTR compared to Group 1 (57% vs. 83% and 51% vs. 91%, p < 0.05).

For treatment of GI, post-pubertal age, female gender, and a positive family history were found to be associated with a CTR both for anticholinergics and BF. In refractory GI cases where methylphenidate was added to the treatment, a history of BF therapy was associated with long-term CTR.