Mixed urinary incontinence: international urogynecological association research and development committee opinion

Abstract

The diagnosis of MUI encompasses a very heterogeneous group of women. The evaluation and treatment requires an individualized approach. The use of validated questionnaires is recommended to assess urinary incontinence symptoms and effect on quality of life. Conservative therapy is suggested as a first-line approach; if surgery is contemplated, urodynamic investigation is recommended. Women undergoing surgical treatment for MUI need to be counselled about the possibility of persistence of urinary urgency, frequency and urge incontinence even if stress urinary incontinence is cured.

Comparison of single-incision mini-slings (Ajust) and standard transobturator midurethral slings (Align) in the management of female stress urinary incontinence: A 1-year follow-up

“…UI affects 10e40% of women, with the most common type known as stress urinary incontinence (SUI) [2]. Risk factors for SUI include increased number of vaginal deliveries, obesity, previous hysterectomy, chronic cough, poor health, depression, and stroke [1].…”

Effects of bariatric surgery on urinary incontinence

“…Research has revealed that both SUI and UUI are more prevalent among patients who experience increase in BMI 6. In accordance, obese and overweight patients tend to undergo surgical treatment for UI more frequently than normal-weight patients 20.…”

“…MUI is the involuntary loss of urine associated with urgency as well as with effort or physical exertion or on sneezing or coughing. Treatment depends on the type of UI, but all types appear to benefit from fluid restriction, regulation of diuretics and other drugs, pelvic floor and Kegel exercises, as well as weight loss 6. Whereas primary treatment of UUI comprises antimuscarinic pharmacotherapy, treatment of SUI via pharmaceutical therapy is more limited, with surgical methods such as placement of a midurethral sling being most commonly used 7…”

Methods for a multicenter randomized trial for mixed urinary incontinence: rationale and patient-centeredness of the ESTEEM trial

“…39 Although pelvic floor muscle exercises are included in UUI treatment, bladder training and strategies to promote skills and behaviors that encourage continence are also critical. 13, 40 …”

“…UUI is thought to be a result of involuntary detrusor muscle contractions, although many women with UUI do not demonstrate detrusor overactivity on urodynamic testing. 13 Primary treatments for UUI are typically behavioral and/or medical.…”