Mixed urinary incontinence: continuing to confound?
OBJECTIVE
Mixed incontinence remains a complex clinical problem for urogynaecologists and generalists alike, as research for new treatments and interventions tend to focus on single-symptom groups. Those with mixed symptoms form a diverse group, which is difficult to study precisely. Recent studies, however, have aimed to classify the subgroups within this heterogeneous group so that the response to treatment can be determined with greater accuracy. This review aims to evaluate these advances and place the research in a clinical context.


RESULTS
The main developments have occurred with the acknowledgement of the large number of patients with these symptoms, the assessment of patients and attempts to classify symptom predominant types. Responses following pharmacological and surgical treatment have also improved.


CONCLUSIONS
There is greater awareness of the prevalence of mixed urinary incontinence, which has a large impact on the quality of life of women, irrespective of their desire to seek medical help. Tools are available to identify different subgroups within the sphere of mixed urinary incontinence, and, once accurately assessed, patients can expect good outcomes from treatment. Further collaboration between units will lead to more consistent information being published.
Hockey
Joanne
J
Department of Obstetrics and Gynaecology, Royal Free Hospital, Hampstead, London, UK. joanne.hockey@royalfree.nhs.uk
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003408:Cresols / Q000627:therapeutic use; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010665:Phenylpropanolamine / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D013876:Thiophenes / Q000627:therapeutic use; D000068737:Tolterodine Tartrate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000145:classification / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014563:Urodynamics / Q000187:drug effects / Q000502:physiology; D013520:Urologic Surgical Procedures / Q000379:methods*
D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D013876:Thiophenes; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; D000068736:Duloxetine Hydrochloride