Mixed Urinary Incontinence: Strategic Approach

Mixed urinary incontinence (MUI) is highly prevalent and associated with a significant impairment in quality of life. The pathogenesis of MUI is unclear, and patients may have stress-predominant MUI, urgency-predominant MUI, or equal stress- and urgency-predominant MUI. There is limited evidence regarding the best initial treatment for women with MUI, though treatment typically begins with conservative therapy for the component of incontinence that is most bothersome to the patient. For women with refractory MUI symptoms, stress incontinence surgery and third-line overactive bladder therapies are reasonable treatment options, and patient factors and urodynamic variables may help guide treatment decisions.