Mixed urinary incontinence is a common type of incontinence which usually comprises of stress and urge urinary incontinence. It is more common in women than in men.
About 14% of women suffering from urinary incontinence have mixed urinary incontinence. It happens due to the stress felt during vaginal delivery. Its other causes involve surgery in the pelvic region, radiation therapy in this region, urinary tract infection, etc. Its symptoms of urine leakage are experienced during laughing, coughing, sneezing or performing exercises. It can be cured with bladder training, pelvic floor exercises, medications, and others discussed below.
What Causes Mixed Urinary Incontinence?
Mixed urinary incontinence is a type of urinary incontinence in which there are symptoms of two or more types of urinary incontinence. It usually has stress and urges incontinence. It affects females more than males. About 45 % of women develop urinary incontinence. Out of this, 14% of women are diagnosed with mixed incontinence. Its symptoms are felt while laughing, coughing, sneezing, or exercising. The patient feels a sudden urge to urinate but the urine leaks before he reaches the toilet. (1)
Mixed urinary incontinence is caused by factors that trigger stress and urge incontinence. Stress incontinence occurs when the pelvic floor muscles weaken due to pressure on the abdomen that eventually weakens the bladder muscles. It is caused by pregnancy, childbirth, surgery or radiation therapy done to the vagina (female) or prostate (males), injuries to the pelvis and obesity. (1)
Urge incontinence develops when there is too much contraction of the muscles of the bladder wall. It occurs due to anxiety, constipation, urinary tract infection and the ailments of the nervous system. (1)
How To Cure Mixed Urinary Incontinence?
The ways to cure mixed incontinence are focused on the treatment of stress and urge incontinence. It can be treated with the following-
Exercises- Kegel exercises or pelvic muscle exercises help in strengthening the bladder muscles and keeping control over the urethra to close. The exercises include squeezing and relaxation of the muscles to hold or evacuate urine. (1)
Bladder Training- bladder training is advised to many patients to control the release of urine and strengthen the bladder muscles. In this training, the patient is asked to go to the toilet in scheduled times such as every 45 minutes. He is advised to increase the time between the toilet visits to achieve full strength on the bladder muscles. (1)
Medicines- medicines such as oxybutynin, tolterodine or darifenacin are prescribed to control the overactivity of the bladder muscles. in certain cases, botulinum toxins are injected in the bladder to calm the muscles. (1)
Procedures To Treat Mixed Urinary Incontinence
In severe cases where urine leakage is excessive, then the following procedures are advised-
Urethral Inserts- these inserts are inserted in the urethra to control leakage. (1)
Pessary- sometimes, the bladder may collapse down on the vagina. A pessary is inserted in the vagina to prevent this collapse and support the walls of the vagina. (1)
Injections- in certain cases, bulking material is injected into the urethra that would keep it closed and reduce the incidences of leakage. (1)
Pelvic Floor Stimulation- electric stimulation is directed to the pelvic floor muscles to contract the muscles and keep the urethra closed to prevent leaking of the urine. (1)
Surgery- in rare cases, surgery is advocated to control the leakage of the urine. In this procedure, tissue from the patient’s own body or a man-made material is used to support the urethra to prevent leakage of urine. (1)
Mixed urinary incontinence is a combination of stress and urges incontinence. It is caused by all the factors that can induce stress and urge incontinence as discussed above. It can be treated with bladder training, pelvic floor exercises, medicines, surgery, and other procedures discussed above.