Elzinga-Plomp A, Boemers T M, Messer A P, Vijverberg M A, de Jong T P, van Gool J D
Department of Paediatric Psychology, Wilhelmina Children's Hospital, University Hospital for Children and Youth, Utrecht, The Netherlands.
Br J Urol. 1995 Dec;76(6):775-8. doi: 10.1111/j.1464-410x.1995.tb00773.x.
To treat enuresis risoria (giggle micturition) by a self-administered electric and imaginary shock and to evaluate the outcome after behavioural therapy.
Six boys and three girls with enuresis risoria were evaluated and treated. The mean age at referral was 10.4 years (range 5.7-14.2). All children had episodes of involuntary complete bladder emptying triggered by hearty laughter or giggling. The frequency ranged from four times per day to twice a week. No other voiding problems were noted. Five patients (four boys and one girl, mean age 10.2 years, range 5.7-14.2) received conditioning training which consisted largely of the self-administration of a harmless, painless electric shock to the back of one hand, at the moment when micturition was induced by laughter, leading to inhibition of the voiding reflex. Later, the electric shock was replaced by an imaginary shock. Training was undertaken on an outpatient basis. A mean of eight sessions, each of 45 min duration, was necessary to train the children. The mean follow-up was 26 months (range 12-51).
The frequency of wetting was reduced by a mean of 89% in all children 1 year after the successful completion of the training. In three children, followed for 2 years, this result stabilized at that proportion. One of these children, followed for > 3 years, gradually reverted to the original pattern of daily wetting and another patient, with a follow-up of > 4 years, maintained an 86% reduction of wetting incidents.
Until now, there was no specific treatment for enuresis risoria and not all patients outgrow the problem; this experimental conditioning programme shows promise in diminishing wetting incidents. However, the programme needs further testing in a prospective study.
采用自我实施的电击和想象性电击疗法治疗笑声引起的遗尿症（笑声性排尿），并评估行为治疗后的效果。
对6名男孩和3名患有笑声性遗尿症的女孩进行评估和治疗。转诊时的平均年龄为10.4岁（范围5.7 - 14.2岁）。所有儿童均有因开怀大笑或咯咯笑引发的非自主性膀胱完全排空发作。发作频率从每天4次到每周2次不等。未发现其他排尿问题。5名患者（4名男孩和1名女孩，平均年龄10.2岁，范围5.7 - 14.2岁）接受了条件训练，主要内容是在因笑声诱发排尿时，对一只手的背部自我实施无害、无痛的电击，从而抑制排尿反射。后来，电击被想象性电击所取代。训练在门诊进行。训练这些儿童平均需要8次疗程，每次疗程持续45分钟。平均随访时间为26个月（范围12 - 51个月）。
在训练成功完成1年后，所有儿童的尿床频率平均降低了89%。3名随访2年的儿童，这一结果稳定在该比例。其中1名随访超过3年的儿童逐渐恢复到每日尿床的原来模式，另1名随访超过4年的患者尿床事件减少了86%。
到目前为止，对于笑声性遗尿症尚无特异性治疗方法，并非所有患者长大后该问题都会自行消失；这一实验性条件训练方案在减少尿床事件方面显示出前景。然而，该方案需要在前瞻性研究中进一步测试。
