Mixed incontinence is a type of urinary incontinence that refers to a loss of bladder control. It may range in severity from occasional, involuntary dribbles of urine to frequent, major bladder leakage. There are different types of urinary incontinence, and mixed incontinence is a condition in which a patient suffers from more than one of these types.
Stress incontinence occurs when the bladder leaks due to an event that causes pressure on it, such as sneezing, coughing, or exercising. Urge incontinence happens when a patient has an intense, sudden urge to urinate, but cannot reach a toilet quickly. Mixed incontinence is often a combination of these two types. It may also include overflow incontinence, which refers to an inability to fully empty the bladder, resulting in frequent dribbles. Mixed incontinence may also include gross total incontinence, which is continual urine leakage caused by the bladder's inability to store or contain urine.
Urinary incontinence of any type is often a symptom of an underlying medical problem or condition. It may be caused by nerve damage or other neurological disorders; complications from a medical procedure, such as a hysterectomy; or it may even be due to pregnancy and childbirth. In some cases, it may simply be due to the aging process. Mixed incontinence can also be caused by some medications, such as muscle relaxants, or it may be a result of dehydration, overhydration, or high caffeine intake. Alcohol consumption may also be a factor.
To help accurately diagnose mixed incontinence, a patient should keep a record of liquid intake and urination for a few days. The patient should also record incidences of incontinence. A doctor may request a blood test and a urinalysis to check for underlying conditions. Other tests may be needed to check for abnormalities or obstructions in the patient's urinary tract.
A combination of different treatment approaches may be recommended, depending on the severity of the case. If the mixed incontinence includes urge incontinence, the doctor may recommend bladder training, which involves training the bladder to wait to urinate after an urge is felt. Stress incontinence may be alleviated with Kegel exercises, which strengthen pelvic muscles. The doctor can teach the patient how to contract these, hold the contraction, and then release. This often helps the muscles involved in bladder control.
If these techniques are insufficient, the patient may also take medications. Incontinence that is a combination of urge and stress incontinence may be alleviated by a tricyclic antidepressant. In severe cases, surgery may be required. There are different types of surgery that can address mixed incontinence, however, the general goal of each procedure is to help provide support to the bladder muscles and keep the urethra closed to prevent involuntary leakage.
