Stress Urinary Incontinence Management in the Patient With Overactive Bladder
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Purpose of the Review
Mixed urinary incontinence is a common diagnosis that has significant impact on patient quality of life and can be more bothersome to patients compared to pure stress incontinence. Given the complexity of concomitant stress incontinence and overactive bladder symptoms, mixed urinary incontinence can often present as a clinically challenging scenario for treating physicians across different subspecialties and primary care medicine. In this review, we discuss the importance of a judicious evaluation and the utility of deciphering stress-predominant versus urge-predominant urinary incontinence in patients with concomitant symptoms.
The temporal relationship between stress incontinence and urgency symptoms has been explored in recent literature. Although a common pathway has been alluded, characterization of the predominant symptom is essential in treating this difficult diagnosis. As suggested in recent guidelines, emphasis should be placed on setting appropriate patient goals of care and discussing treatment expectations in order to best optimize patient satisfaction and patient-reported treatment success. Risks, benefits, and alternatives for both stress urinary incontinence and overactive bladder treatment options should be reviewed, yet there is lack of a standardized approach in the literature.
We outline a sequential algorithm to help guide patient counseling, management, and appropriate expectations for treatment of mixed urinary incontinence.
KeywordsMixed urinary incontinence Evaluation Management
Compliance With Ethics Guidelines
Conflict of Interest
Dr. Lucioni and Dr. Amin declare that they have no conflicts of interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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