Health news
Health news top Health news

   Login  |  Register    
Health News Make AMN Your Home PageDiscussion BoardsAdvanced Search ToolMedical RSS/XML News FeedHealth news
You are here : > Health Centers > Clinical Obstetrics and GynecologyUrinary Incontinence

Mixed Incontinence

Urinary IncontinenceDec 20, 06


Mixed incontinence occurs when both stress incontinence and DI occur simultaneously. Patients may present with symptoms of both types of incontinence. These patients present both a diagnostic and therapeutic dilemma. The prevalence of mixed incontinence is more common than most practitioners realize. A detailed history will reveal symptoms of SUI with urine loss associated with cough, sneeze, or other increase in Valsalva pressure, as well as urinary urgency, frequency, and concomitant incontinence. The coexistence of these 2 conditions may be brought about by many causes. Patients with stress incontinence often preemptively urinate to avoid a full bladder and subsequent urine loss, thereby conditioning the bladder to habituate to a low functional capacity. This may promote premature signaling of bladder fullness and result in frequent urge symptoms.

Patients may have DI that is precipitated by coughing or laughing. Patients may have indolent involuntary bladder contractions that only manifest with the additional pressure of a cough, sneeze, or laugh. The cause is often difficult to ascertain, but the diagnosis should be confirmed with urodynamic studies that can assist in identifying the cause of urine loss.


For mixed incontinence, treatment should be based on the patient’s worst symptoms. Often patients can prioritize their symptoms, stating that one component impacts their life more than the other. By having the patient separate the symptoms, a practical management plan with realistic expectations can be devised. A great disservice can be done by operating on a patient to restore bladder neck support and remove stress symptoms, when the patient’s main concern is daily urge incontinence while she is at work. Conservative measures should be tried first, and if symptoms do not improve surgical measures can be entertained to target alleviation of the stress component. However, there is a 50-60% chance that urge symptoms may resolve after a midurethral sling is performed. Occasionally the involuntary contractions are alleviated by restoration of bladder support and vaginal anatomy.


Provided by ArmMed Media
Revision date: June 14, 2011
Last revised: by Tatiana Kuznetsova, D.M.D.

Email this to a friend Bookmark this! Printable Version


We are pleased to let readers post comments about an article. Please increase the credibility of your post by including your full name and email.

All comments are reviewed by our editors before they are posted on the site. Just keep it clean, kids. Commenting is not available in this weblog entry.

   [advanced search]   
Interactive Quiz:
1. The most common form of contraception used by couples in the United States is
Intrauterine device (IUD)
Permanent sterilization

Health Centers
  Pediatric & Adolescent

  Teenage Pregnancy

  Contraception for Adolescents

  Delayed Puberty

  Menstrual Irregularities

  Adolescent Dysmenorrhea


  Ovarian Masses

  Breast Diseases

  Sexually Transmitted Diseases

  Chronic Pelvic Pain
  Gynecologic Clinical

  Imaging in Pediatric

  Ambiguous Genitalia in the

  Ovarian Cysts

  Precocious Puberty

  Sexual Abuse

  Vulvo-Vaginal Disorders



  Premenstrual Syndrome




  Cervical Polyps

  Genital Prolapse

  Uterine Prolapse

  Pelvic Inflammatory Disease

  Ovarian Tumors

  Painful Intercourse



  Menopausal Syndrome


  Urinary Incontinence


  Stress Urinary Incontinence

  Urge Urinary Incontinence

  Mixed Incontinence

  Overflow Incontinence

  Bypass Incontinence

  Pregnancy Health Center

  Gynecologic cancers


  Diagnosis of pregnancy

  Essentials of Prenatal care

  Nutrition in Pregnancy

  Morning Sickness

  Spontaneous Abortion

  Recurrent (Habitual) Abortion

  Ectopic Pregnancy


  Third-trimester Bleeding

  Surgical Complications

  Hemolytic Disease Prevention

  Premature Labor Prevention

  Puerperal Mastitis

» » »

Health Centers


Health news

Health Encyclopedia

Diseases & Conditions

Drugs & Medications

Health Tools

Health Tools

   Health newsletter


   Medical Links

   RSS/XML News Feed


Add to Google Reader or Homepage
Clinical Obstetrics and Gynecology News, Headlines and Latest Stories on
Add to My AOL