Clinical and urodynamic effect of methylphenidate for the treatment of giggle incontinence (enuresis risoria).

Abstract

AIMS:

We retrospectively investigated the efficacy of methylphenidate (MPH) in giggle incontinence (GI), and the relationship between GI and urodynamic parameters.

METHODS:

Nine (n = 9) female GI patients underwent 1 year of treatment with 5 mg MPH. Three questionnaires, voiding diaries, and UDS were conducted before and after treatment. The severity of GI was classified into mild, moderate, and severe. Clinical success was characterized as: full response, response, partial response, and non-response.

RESULTS:

The mean age of all patients was 16.2 ± 2.3 years. Five patients had mild, one had moderate, and three had severe grade incontinent. All patients reported complete cessation of wetting after MPH treatment. The mean duration of asymptomatic period was 7 ± 3.2 months. There were no statistically significant score changes in all three questionnaires: Urgency Perception Scale (UPS), Overactive Bladder Symptom Score (OABSS) and Primary Overactive Symptom Questionnaire (POSQ), and voiding diaries (P > 0.05). In UDS, there were no statistically significant altered parameters, except maximum urethral closure pressure (MUCP) and maximum urethral pressure (MUP). After treatment, the mean MUCP was increased from 52.2 ± 6.8 to 73.0 ± 5.4 cmH(2) O (P < 0.05), and the mean MUP was increased from 48.6 ± 7.3 to 70.2 ± 5.0 cmH(2) O (P < 0.05).

CONCLUSIONS:

MPH can be a viable option for the primary treatment of GI, and it may be related to increasing urethral closure pressure. It was not possible to establish if a relationship between GI and detrusor overactivity exists.

• Authors: Joo-Hyun Chang, Kwang-Yeom Lee, Tae-Beom Kim, Sang-Jin Yoon, Tack Lee, Khae-Hawn Kim
• Journal: Neurourology and urodynamics (Neurourol Urodyn) Vol. 30 Issue 7 Pg. 1338-42 (Sep 2011) ISSN: 1520-6777 [Electronic] United States
• PMID: 21520251 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Wiley-Liss, Inc.

Chemical References

• Central Nervous System Stimulants
• Methylphenidate

Topics

• Adolescent
• Central Nervous System Stimulants (therapeutic use)
• Child
• Enuresis (diagnosis, drug therapy, etiology, physiopathology)
• Female
• Humans
• Laughter
• Methylphenidate (therapeutic use)
• Retrospective Studies
• Severity of Illness Index
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome
• Urinary Bladder (drug effects, innervation, physiopathology)
• Urodynamics (drug effects)
• Young Adult