Prevalence of mixed urinary incontinence

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Hypothesis, aims of study. Mixed incontinence can be defined, as involuntary leakage of urine associated with both urgency and exertion, and effort, sneezing, and/or coughing. It can also be defined urodynamically, as combination of urodynamic stress incontinence and detrusor overactivity. The aim of this study was to describe the prevalence of mixed incontinence among the patients of urologic clinic. In addition we analysed short-term outcome data in patients with mixed incontinence who underwent anti-incontinence surgery.

Study design, material and methods. We evaluated 363 women with symptoms of urinary incontinence between March 2004 and May 2005, mean age 52,3 (age range: 39-67 years). In this retrospective study, we examined the records of 269 women (74%) after antiincontinence procedures. Clinical evaluation included complete history, physical examination, three days voiding diary and urinary questionnaire (DAN-PSS). A urodynamic investigation was perfomed in 27% of patients and consisted of free-uroflowmetry, pressureflow study, cystometry, EMG and UPP. The machines used include Duet MultiP (Medtronic) and Bonito (Laborie). Either an 8Fr filling catheter to measure vesical pressure (pves), or 8Fr double-lumen catheter was used. All urodynamic investigations were done according to the ICS good urodynamics practices protocol.

Results. Mixed incontinence was symptomatically revealed in 99 patients (27%). Overactive bladder was urodynamically confirmed in 42 patients (42,4%) and conservative management was provided for this group.

In other cases various anti-incontinence procedures were performed. The total number of patients was 57. Twelve patients (21%) still had persisting symptoms after the operation. Eight patients (14%) showed poor function results.

Concluding message. The prevalence of mixed incontinence in our practice was 27%. Detrusor overactivity was confirmed urodynamically in 42 patients (42,4%) with mixed incontinence. Our experience showed that patients with symptomatic mixed incontinence deserved specific attention in order to prevent recurrence of urge symptoms after surgical procedures. Urodynamic investigation is the only objective test for diagnosing of urinary incontinence. Given the danger of exacerbating urge symptoms with surgery, these results suggest that while managing mixed incontinence, the physician should treat detrusor overactivity first.

About the authors

D. Y. Pushkar

Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: info@eco-vector.com

Urological Department

Russian Federation, Moscow

О. В. Shaveleva

Moscow State University of Medicine and Dentistry

Email: info@eco-vector.com

Urological Department

Russian Federation, Moscow

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