Mixed Incontinence Archives

Urinary incontinence terminology sometimes adds confusion to the existing troubles of the patient. There is more to a medical term, however, than just a label. Correctly identifying the type of incontinence that a patient is suffering from offers a more specific diagnosis of the problem and improves their chances of receiving the proper treatment. However, mixed incontinence is a diagnoses that may leave a patient wondering: what is mixed incontinence?

Simply put, mixed incontinence is a combination of two types of incontinence, which are the following: stress incontinence and urge incontinence. Mixed incontinence is one of the most common types of incontinence in female patients and the elderly population. The presenting symptoms of stress incontinence are the leakage of urine upon laughing, coughing or sneezing, mixed with urge incontinence symptoms. Therefore, when a patient feels the urge to urinate, the patient is also unable to hold urine long enough to reach the bathroom.

Mixed incontinence occurs because of the overlap of two distinct medical problems: bladder muscle over activity, resulting in involuntary emptying of the bladder when full, and weakening of the sphincter charged with closing the bladder. This weakened sphincter muscle results in leakage as there is an increase in the pressure on the bladder by the surrounding organs. The bladder muscle over activity, leading to the development of urge incontinence, can be caused by conditions as simple as urinary tract infections, an abnormally large urinary volume output, or by hard to treat conditions such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.

Usually, patients present with one set of symptoms, the most pressing, either urge or stress incontinence and may not even be aware of the other symptoms. In many instances, females with mixed incontinence complain of urine leakage during coughing or sneezing, but fail to recognize that they suffer from an abnormal urgency to reach the bathroom. In other instances, they assume the urgency to be somehow related to their stress incontinence and assume that if they treat one the other will simply go away. Because of this, mixed incontinence can present a diagnostic challenge to the doctor. This dilemma can be sorted out through careful history taking and enquiring about the circumstances where urinary leakage occurs.

Mixed incontinence is treated through a combination of the methods used for treatment of urinary stress incontinence and urge incontinence. The doctor decides on the methods of treatment according to the underlying pathologies, severity of the symptoms, and lifestyle preferences of the patient. Treatment options include behavioral modification, biofeedback, vaginal pessaries, urethral plugs, compression rings and clamps, and even surgery. Simple measures such as Kegel exercises, regularly emptying the bladder without waiting for the urge to urinate, and removing medications which exacerbate incontinence usually bring relief in mild cases of mixed incontinence.

The answers to the questions, what is mixed incontinence, and what are its presenting symptoms, have to be clear in the minds of urinary incontinence patients; because successful management begins with proper diagnosis.

Incontinence is suffered by millions of people worldwide. There are many different causes for incontinence, and while some fall neatly into one category or another, others, like mixed incontinence, do not. For example, stress incontinence is triggered by pressure to the abdomen, like a sudden sneeze or laugh. This type of incontinence is usually the result of weak or damaged pelvic floor muscles.

Another type of incontinence is known as urge incontinence, which presents as a sudden and overwhelming need to go to the bathroom. However, some people actually have symptoms of both of these types of incontinence, and when they do it is known as mixed incontinence.

The symptoms of mixed incontinence are exactly what one would expect, where symptoms from each type of incontinence, stress and urge, can manifest themselves. The symptoms and severity varies from person to person; however, mixed incontinence always shows signs of both stress incontinence and urge incontinence. One type may be more strongly indicated than the other, but if shared symptoms exist, then the condition is known as mixed incontinence.

Just as mixed incontinence shares the symptoms of stress and urge incontinence, it also shares the causes. Since stress incontinence is typically caused by weak or damaged pelvic floor muscles, the number one contributor to a condition of stress incontinence is pregnancy and childbirth. This is why a disproportionately large number of women suffer from incontinence. Other factors that can contribute to stress incontinence is surgery, medication, lower hormone levels as found in menopause, a smoker’s cough, or just about anything the strains or damages the pelvic floor muscles.

Typically a result of nerve damage, urge incontinence can be caused by surgery, stroke, injury or disease, like Alzheimer’s, Parkinson’s or multiple sclerosis. Diabetes and hyperthyroidism can also exacerbate the symptoms of urge incontinence.

Mixed incontinence may be a little tricky to diagnose properly, because of the overlapping symptoms, so it is always best to enlist the aid of a healthcare professional when determining the type and causes of an incontinence problem. When discussing an incontinence problem with a physician, be prepared to answer questions relating to the problem. The type of information that a physician will be looking for is patterns of eating and drinking, patterns of urination, and patterns of leakage or accidents. In understanding the patterns and the relationship between the patterns, a doctor can devise a plan for treatment, and often this type of incontinence can be successfully treated.

When diagnosing incontinence, a physician typically will want to make a physical examination of the patient and search for any nerve damage that may be present. Depending on what the doctor discovers, it may be advisable to also seek the council of a neurologist, or a doctor may perform more specific testing. Once the doctor has determined the underlying cause of the incontinence, he or she will be able to recommend a course of treatment.

Since mixed incontinence is exactly what it says, a mix of two different types of incontinence, it may very well need to be approached from several different angles. Since there is not one, cookie cutter solution for everyone, a doctor looks at the complete patient before making a recommendation, considering age, lifestyle and severity of the condition.

Treatment for mixed incontinence can be any one or combination of the the classic treatments for stress incontinence or urge incontinence, which range from Kegel exercises to surgery and everything in between.

Disclaimer: All material published on the Incontinence.co.uk web site is for informational purposes only. Readers are encouraged to confirm the information contained herein with other sources. The information is not intended to replace medical advice offered by your doctor or health professional. Readers should always discuss health matters and review the information carefully with their doctor or health care professional. Extended Disclaimer