title: Clinical and urodynamic effect of methylphenidate for the treatment of giggle incontinence (enuresis risoria).
abstract: OBJECTIVE
  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.affiliation: Department of Urology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Chang
authors.forename: Kwang-Yeom
authors.initials: KY
authors.lastname: Lee
authors.forename: Tae-Beom
authors.initials: TB
authors.lastname: Kim
authors.forename: Sang-Jin
authors.initials: SJ
authors.lastname: Yoon
authors.forename: Tack
authors.initials: T
authors.lastname: Lee
authors.forename: Khae-Hawn
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D004775:Enuresis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007845:Laughter; D008774:Methylphenidate / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D014563:Urodynamics / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate