Mixed Incontinence

A Few Facts About Mixed Incontinence

Mixed incontinence is a combination of two of the more common types of incontinence, stress incontinence and urge incontinence. Urge incontinence, the subject of numerous TV advertisements, is characterized by the need to make a mad dash for the restroom, and the major symptom is a loss of urine very soon after the urge appears. Stress incontinence is somewhat of a more sensitive subject when it comes to TV advertisements, as the main symptom is a loss or leakage of urine when one coughs or sneezes, or through some sudden movement that puts pressure on the bladder.

It would be logical to assume that mixed incontinence is somewhat less common than either stress or urge incontinence, but the truth is more people, primarily women, suffer from mixed incontinence that from either of the other two major types. Stress incontinence is the result of weakened muscles which control or support the bladder, while urge incontinence is usually the result of involuntary movements of the bladder muscle, often due nervous system problems, which in turn can be brought about by diseases or injuries.

Mixed incontinence, while a physical problem, is not always cured by surgery alone, in fact surgery is but one of several treatment options. Even if a mechanical problem is eliminated, the mental aspects of incontinence may linger. In other words the patient may still experience seemingly uncontrollable urges to urinate. A combination of medication, exercise, and biofeedback, particularly the latter, is then put into play to train both body and brain to control the urges.

Kegel Exercises To The Rescue - As mentioned, weakened muscles are the usual cause of stress incontinence, and treatment consists of exercises designed to strengthen the affected muscles. Fortunately there are exercises, called Kegel exercises, which can strengthen the muscles in the pelvic region, giving the patient more control over those muscles, where before control may have been minimal or absent. These include the same muscles which we use when wanting to avoid passing gas, so if they are weakened, the door is open to potentially embarrassing situations. Kegel exercises, when faithfully followed, generally result in strengthening and greater control over these muscles, and the exercises go hand in hand with the principles of biofeedback.

Surgical Procedures And Medication - In some instances surgery is the best option, and there are different surgical procedures which can be implemented, ranging from open abdominal surgery to a laparoscopy. Surgery to treat mixed incontinence, or stress incontinence or urge incontinence for that matter, has a good track record, with roughly 9 out of 10 patients fully regaining urinary control. Not everyone desires or requires surgery however, and in many instances medications will suffice, with the most commonly used being one of several bladder relaxing medications such as oxybutinin.

Diagnostic Tests And Tools - Effective treatment of mixed incontinence of course depends upon the correctness of the diagnosis. It's important that the patient be able to tell the doctor in detail what the symptoms and experiences have been, and the patient may even be asked to keep a log or journal as treatment progresses to assist the doctor in providing the best remedy. There are also a number of diagnostic tests a patient may need to undergo to pinpoint exactly what is causing the incontinence problem. A bladder stress test may be conducted, or the bladder may be tested for leakage when the patient is asked to cough. A catheter may be used to determine if the bladder, once emptied, actually has been emptied or still contains an appreciable amount of urine. There are a number of other diagnostic tests as well, including some based on ultrasound technology. These tests are often necessary, as the root causes of mixed incontinence often vary significantly from person to person.