Clinical review published in JAMA

Many women experience bothersome urine loss with laughing, coughing and sneezing (stress urinary incontinence) AND on their way to the bathroom (urge urinary incontinence). When women experience both types of urine leakage, their condition is called mixed urinary incontinence. It is estimated that 20 to 36 percent of women suffer from mixed urinary incontinence, which is challenging to diagnose and treat because symptoms vary and guidelines for treatment are not clear.

A clinical review entitled "Clinical Crossroads – Female Mixed Urinary Incontinence" by Deborah L. Myers, director of the Division of Urogynecology and Reconstructive Pelvic Surgery at Women & Infants Hospital of Rhode Island and The Warren Alpert Medical School of Brown University, has been published in the May 21, 2014 edition of the Journal of the American Medical Association (JAMA).

"Because mixed urinary incontinence involves both types of incontinence, it is difficult to treat. Our goal was to review the diagnosis and management of mixed urinary incontinence in , with a focus on current available evidence," said Dr. Myers.

Dr. Myers reviewed 73 published articles that discussed the prevalence, diagnosis, results, and treatment of mixed urinary incontinence. She found that there is high-quality evidence for treating urinary incontinence with weight loss, for treating with surgery, and for treating urge urinary incontinence with medications.

"However, there is a lack of direct, high quality evidence for treating women with mixed urinary incontinence, as well as an absence of clear, diagnostic criteria and management guidelines for these patients. Because of this, treatment usually begins with conservative management emphasizing the most bothersome component," continued Dr. Myers. "There is a clear need for randomized trials in women with mixed urinary incontinence."

Women & Infants Hospital is currently a member of the Pelvic Floor Disorders Network (PFDN), a team of doctors and researchers from eight clinical research centers around the country funded by the National Institutes of Health to improve the level of knowledge about pelvic floor disorders such as an overactive bladder. Through research studies, the team will be able to identify the most effective ways to care for women.

Through their participation in the Pelvic Floor Disorders Network, Dr. Myers and her colleagues are currently recruiting patients for the ESTEEM Study – Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence. Vivian Sung, MD, MPH, of Women & Infants Hospital and the Alpert Medical School, is the principal investigator of this national study comparing two approaches for treating mixed (MUI) in women, a midurethral sling alone or a midurethral sling combined with behavioral muscle therapy before and after surgery.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Recorded Ebola deaths top 7,000

8 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

12 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.