Mixed Incontinence

Introduction

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.

Urinary Incontinence

• Urinary Incontinence
• Anatomy
  L Introduction
  L Neuroanatomy
• Urinary Incontinence - Overview
  L Definition
  L Etiology
  L History
  L Patient Questionnaires
  L Voiding Diary
  L Urinalysis
  L Physical Examination
  L Cotton Swab Test
  L Urinary Cough Stress Test
  L Neurologic ExaminationL L L