Abstract

Mixed Urinary Incontinence (MUI) in women is an important disease that is under-treated and under-reported with high prevalence of 33% of all cases of incontinence. It significantly impairs women’s quality of life. MUI usually represent with more severe symptoms and are more likely to present for the treatment as per the recent studies. The management not only includes the conventional but also the complementary and alternative medicine treatment incorporating details from evidence to clinical practice. Combinations of behavioral modification, pelvic floor physiotherapy, biofeedback, pharmacotherapy, anti-incontinence devices, and complementary therapies is useful to treat mixed symptoms. Some researches recommended the use of Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) and antimuscarinic drugs to treat MUI. Some studies showed that acupuncture is beneficial for MUI. The treatment with herbal medicine such as mace, Boswellia serrata and Cyperius were also effective in treating MUI symptoms.

Highlights

  • “Urinary incontinence is defined by International Continence Society (ICS) as involuntary leakage of urine”[1]

  • Urinary Incontinence (UI) prevalence in 15 to 64 year females ranges from 10% to 55% and in about 38% of elderly females’ urinary leakage is severe to classify as a “urinary incontinence problem” within this group[15]

  • Studies have proven that a weight loss of 8% in obese women showed a decrease in overall UI per week and Urgency Urinary Incontinence (UUI) episodes by 47% and 42% vs 28% and 26% in controls, respectively

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Summary

Introduction

“Urinary incontinence is defined by International Continence Society (ICS) as involuntary leakage of urine”[1] It is “a symptom[1,2], sign, as well as a condition”[3]. 1.1 Definition “Urinary incontinence is defined by the International Continence Society (ICS) as involuntary loss of urine”. A study explored “various definitions of MUI using validated research instruments in women with urge predominant MUI”. They found that the prevalence of MUI between 72% and 96% by using the “Medical, Epidemiological, and Social Aspects of Aging (MESA) questionnaire”. Another study found comparable variation in rates of MUI described for women seeking surgical intervention for stress incontinence These rates of MUI varied from 50.4% to 93.3% using similar MESA and UDI based definitions[13]. If incontinence is objectively shown the term “mixed incontinence”, is clinically useful and if incontinence is subjectively reported by patients the term “mixed symptoms of incontinence” is clinically useful[11]

Prevalence
Risk Factors
Sex and menopause
Obesity
Parity
2.10 Smoking and Chronic Lung Disease and Other Habits
2.11 Depression
Evaluation of MUI
Physical Activity
Sexual Dysfunction
Clinical Examination and Investigation
Bladder Diary
Pad Test
Cough Stress Test
Urinalysis
Urodynamic Study
Complications of Urinary Incontinence
10. ICIQ-SF Questionnaire
11. PISQ-12 Questionnaire
12. Management
13. Conservative Management
14. Pharmacotherapy
15. Surgery
15.1 Clinical Trials
15.2 Complementary and Alternative Medicine
16. Clinical Trials
17. Conclusion
18. References
Full Text
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