Some shows are best defined by their audience. This is certainly true of Gusset Grippers, which combines the previously disparate forms of stand-up comedy and incontinence physiotherapy. Incontinence affects 1 in 3 women and 1 in 9 men, so it is likely that some, if not most, of the audience had first-hand experience. Laughter can lead to leakage if you have stress incontinence so given the hilarity throughout, some of us were probably experiencing it during the show itself.

The audience effectively had an hour-long consultation with physiotherapist Elaine Miller. Not the first health professional to go into comedy, she is unusual in using her routine to do her job. Unlike Harry Hill, who left medicine to become a comic, or even Phil Hammond, who remains a GP, Miller uses this show as explicit health promotion - with the emphasis on “explicit”.

Rather than invite audience questions, as was the case in Brian Lobel’s Sex, Cancer and Cocktails, for example, Miller grants us anonymity in this clinical encounter. No one has to share their story - through experience with clients and her own incontinence following the birth of her third child, she knows what we want to ask, why we didn’t go to the doctor, and what mistakes we will make learning the most effective treatment: pelvic floor exercises.

And with an anonymous group rather than an individual client, she is free to exploit every rude joke going about our most intimate body parts and functions. That must be why there was a hen party in on the night I was there. A few years ago, a show called Incontinental avoided “all the obvious and cheap jokes” around incontinence according to a review in Exeunt; by contrast, Miller’s frank descriptions of pish, poo, sex, birth and pelvic anatomy elicited constant laughs of embarrassment and recognition. Her approach is, in many ways, vulgar - in terms of her language, yes, but her directness and practicality as well.

Also in the audience were health professionals earning credits towards their continuing professional development (CPD). CPD helps practitioners like physios and doctors keep their skills and knowledge up to date, and each year they are required to do a certain amount of learning beyond their formal qualifications in order to stay registered with the General Medical Council or the Health and Care Professions Council. Miller's show qualifies as CPD because it is rigorously evidence-based, but she is interested in another type of evidence, too: by following up with consenting audience members, she will assess whether comedy really is an effective tool for health promotion. In this case, I really think it is. (MR)

Gusset Grippers is on at 18.00 until the 28th August (not 10th, 17th, 24th) at Woodland Creatures (Venue 282).

Find out more about Gusset Grippers and Elaine Miller online:  

NHS Choices has somewhat drier information about incontinence:  

Dr Phil Hammond has two shows at the Fringe this year:

Sex, Cancer and Cocktails, by The Sick of the Fringe’s very own Brian Lobel, is reviewed here:

Kazuko Hohki’s Incontinental was reviewed by Exeunt in 2012:

The Health and Care Professions Council explains continuing professional development (CPD) here:

More about CPD for doctors from the Royal College of Physicians of Edinburgh: