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Mixed incontinence: Consider asking about surgery

An elderly woman consults with her doctor.

Oct. 10, 2019—Surgery is not usually the first treatment for mixed urinary incontinence in women. But a new study funded by the National Institutes of Health suggests it may benefit women dealing with the condition.

Understanding mixed incontinence

Urinary incontinence—the involuntary leaking of urine—is common. It affects up to 58% of all women. As many as half of that group have mixed urinary incontinence. Mixed urinary incontinence means having symptoms of both urgency and stress incontinence.

Urgency incontinence involves sudden urges to urinate. Stress incontinence occurs when urine leaks due to pressure from a sneeze, laugh or movement.

The usual treatment for mixed incontinence is to treat its two forms separately. For urgency incontinence, treatment techniques can include:

  • Exercises.
  • Delaying urination.
  • Reducing liquids.
  • Medication.

Stress incontinence is usually treated with exercises. Surgery may be offered later on if symptoms don't improve.

Surgery helps symptoms

For this study, all of the women involved were treated with surgery. Surgery involved placing a thin strip of mesh under the urethra. This helps prevent urine from leaking out. The women were then divided into two groups:

  • Surgery alone.
  • Surgery plus physical therapy.

They were followed for one year. At the end of the year the women filled out a survey about their urinary symptoms. There was a small difference in symptom relief between the two groups, but it wasn't considered clinically important.

Still, the combined surgery and physical therapy group had fewer occasions of incontinence than the surgery alone group. They also were less likely to need further treatment for urinary tract symptoms.

The authors of the study suggested that surgery could be offered earlier on as a treatment method for women with mixed urinary incontinence. Physical therapy could be offered in addition.

The study was published in JAMA.

Tips for talking about bladder control

Do you find it hard to talk to your doctor about incontinence? Here's some helpful advice.

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