International Urogynecology Journal

, Volume 25, Issue 10, pp 1303–1312

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

  • Dorothy Kammerer-Doak
  • Diaa E. E. Rizk
  • Olanrewaju Sorinola
  • Wael Agur
  • Sharif Ismail
  • Tony Bazi
Special Contribution

DOI: 10.1007/s00192-014-2485-8

Cite this article as:
Kammerer-Doak, D., Rizk, D.E.E., Sorinola, O. et al. Int Urogynecol J (2014) 25: 1303. doi:10.1007/s00192-014-2485-8

Abstract

Background and aim

The definition as well as the treatment of women with mixed urinary incontinence (MUI) is controversial. Since women with MUI are a heterogeneous group, the treatment of MUI requires an individual assessment of the symptom components: stress urinary incontinence, urinary urgency, urgency urinary incontinence, urinary frequency, and nocturia. The purpose of this paper is to summarize the current literature and give an evidence-based review of the assessment and treatment of MUI.

Methods

A working subcommittee from the International Urogynecological Association (IUGA) Research and Development (R&D) Committee was formed. An initial document addressing the diagnosis and management of MUI was drafted based on a literature review. After evaluation by the entire IUGA R&D Committee, revisions were made, and the final document represents the IUGA R&D Committee Opinion on MUI.

Results

This R&D Committee Opinion reviews the literature on MUI and summarizes the assessment and treatment with evidence-based recommendations.

Conclusions

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.

Keywords

Mixed urinary incontinenceIUGA research & development committee opinion

Abbreviations

IDO

idiopathic detrusor overactivity

IES

Intravaginal electrical stimulation

QOL

quality of life

MUI

mixed urinary incontinence

MUCP

maximum urethral closure pressure

OAB

overactive bladder

PFMT

pelvic floor muscle training

POP

pelvic organ prolapse

PVR

post-void residual

RCT

randomized controlled trial

SNRI

serotonin norepinephrine re-uptake inhibitor

SUI

stress urinary incontinence

TVT

tension free vaginal tape

UUI

urgency urinary incontinence

UI

urinary incontinence

USI

urodynamic stress incontinence

Copyright information

© The International Urogynecological Association 2014

Authors and Affiliations

  • Dorothy Kammerer-Doak
    • 1
  • Diaa E. E. Rizk
    • 2
  • Olanrewaju Sorinola
    • 3
  • Wael Agur
    • 4
  • Sharif Ismail
    • 5
  • Tony Bazi
    • 6
  1. 1.Women’s Pelvic Specialty Care P.CUniversity of New Mexico HospitalAlbuquerqueUSA
  2. 2.The Canadian Continence Foundation, Peterbotough, Canada, and Department of Obstetrics and Gynaecology, Faculty of MedicineAin Sham UniversityCairoEgypt
  3. 3.South Warwickshire NHS Foundation Trust WarwickUniversity of WarwickCoventryUK
  4. 4.NHS Research ScotlandUniversity Hospital Crosshouse KilmarnockScotlandUK
  5. 5.Brighton and Sussex University Hospitals and Brighton and Sussex Medical SchoolBrightonEngland, UK
  6. 6.American University of Beirut Medical CenterBeirutLebanon