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Mani Arumugam

Do you experience a sudden urge to pee that is uncontrollable? Or perhaps you leak a little urine when you laugh or sneeze? These embarrassing moments can be frustrating and affect your confidence, but you're not alone.

Mixed incontinence, a combination of stress and urge incontinence, affects millions of people worldwide. Despite being a common issue, many people are hesitant to talk about it, leaving them suffering in silence.

The good news is that there are solutions available that can help manage mixed incontinence. In this blog, we're going to break down everything you need to know about mixed incontinence, from its symptoms and causes to the available treatments. So, let's dive in and start taking control of your bladder and your life!

Mixed incontinence – a combination of stress and urge incontinence

Mixed incontinence is a type of urinary incontinence that occurs when an individual experiences a combination of stress incontinence and urge incontinence.

Stress incontinence is when there is an involuntary loss of urine due to physical stress on the bladder, such as coughing, sneezing, laughing, or exercise. Urge incontinence, on the other hand, is when there is a sudden and intense urge to urinate, followed by an uncontrollable loss of urine before reaching the toilet.

People with mixed incontinence may experience both of these types of symptoms, leading to urine leakage during physical activity or when they feel the urge to urinate.

Symptoms of mixed incontinence

Because mixed incontinence is a combination of both stress and urge incontinence, it shares the symptoms of both. You might have mixed incontinence if you leak urine:

  • After a sudden, strong urge to urinate

  • While you sleep

  • When you cough, sneeze, or do any sudden exercise

  • After drinking a small amount of water or liquid

  • When you touch water or hear it run

Causes of Mixed Incontinence

As you might expect, mixed incontinence is caused by the same factors as stress and urge incontinence. Some mixed incontinence causes include:

  • Weak pelvic floor muscles

Overactive bladder:

A condition where the bladder muscles contract involuntarily, causing a sudden urge to urinate.

Psychological factors:

Anxiety, stress, and depression can affect the bladder's nerve signals and lead to an overactive bladder and urge incontinence.

Hormonal changes:

Menopause and hormonal imbalances can lead to changes in the bladder and urinary tract, increasing the risk of mixed incontinence.


Being overweight or obese can put pressure on the bladder and increase the risk of stress incontinence.

Bladder irritation:

Bladder irritation caused by infections, tumors, or stones can lead to an overactive bladder and urge incontinence.

Neurological disorders:

Neurological conditions such as Parkinson's disease, multiple sclerosis, or stroke can affect the bladder's nerve signals and cause mixed incontinence.


Certain medications such as diuretics, sedatives, and muscle relaxants can cause mixed incontinence as a side effect.

Chronic cough:

A chronic cough due to smoking, allergies, or respiratory problems can cause stress incontinence.

Previous pelvic surgery:

Previous pelvic surgeries, such as a hysterectomy, can damage the pelvic muscles and cause stress incontinence.

It is important to correctly identify the underlying cause of urge incontinence to develop an effective treatment plan. And how do we correctly identify it?

Mixed incontinence diagnosis

To find the underlying cause behind your urine leakage, your doctor might ask you to keep a diary for a few days to record when you urinate (purposely or by accident, both), number of times you urinate, amount of urine, and your fluid intake.

Additionally, your doctor may also perform a physical examination to look for nerve damages and weakness in the pelvic floor muscles. They may also perform a number of tests like:

  • Urinalysis

  • Bladder stress test

  • Catheterization

  • Cystoscopy

  • Ultrasound or MRI

  • Urodynamic testing

Treatment for mixed incontinence

Mixed incontinence treatment will require a combination of approaches that address both stress and urge incontinence.

There is no one cure-all treatment for everyone. The treatment you and your doctor will choose will depend on a number of factor like your age, medical history, health, severity of your incontinence, your lifestyle, and preferences.

Treatment options for mixed incontinence include:

Behavioral therapies

Bladder training: A type of behavioral therapy that involves gradually increasing the amount of time between bathroom visits to help you regain control over your bladder again.

Fluid management: the process of regulating the amount and timing of fluids consumed.

Pelvic Floor Muscle Exercises: Also known as Kegels, these exercises help to strengthen the pelvic floor muscles and the muscles that control the bladder. To do Kegels, locate the pelvic floor muscles by stopping the flow of urine midstream. The muscles you just used are your pelvic floor muscles that you need to train. Now squeeze and hold those muscles for 5-10 seconds, and then relax for the same amount of time. Repeat the exercise 10-15 times in a row, and aim to do this 3 times a day.

Dietary changes: Avoiding bladder irritants such as caffeine, alcohol, and carbonated drinks. Eating high-fiber foods that can help prevent constipation which can worsen symptoms of mixed incontinence.

Medical Therapies

Medications: Your doctor may prescribe a medication called an anticholinergic to help relax bladder muscles and reducing spasms. Alternatively, your doctor might change a medication you might be taking that increases urine output and contributes to incontinence.

Estrogen therapy: For women, low estrogen levels can contribute to incontinence. Estrogen therapy may help improve symptoms by strengthening the muscles and tissues in the pelvic area.

Injections: After administering local anesthesia, your doctor injects bulking agents into the tissues around the bladder neck and urethra to minimize urine leakage.

Surgical Therapies

Mid-urethral sling surgery: The most common surgical treatment for stress incontinence. It involves placing a sling, made of synthetic mesh or tissue, under the urethra to provide support and prevent urine leakage. The procedure is minimally invasive and can be done on an outpatient basis.

Bladder neck suspension surgery: This surgery involves repositioning the bladder and urethra to provide additional support to the bladder neck and reduce stress incontinence. The procedure is typically done under general anesthesia.

Artificial Urinary Sphincter: A device is implanted around the urethra to help control the flow of urine. The device is controlled by a pump that is placed in the scrotum or labia. This surgical procedure is generally reserved for severe cases of stress incontinence.

Sacral nerve stimulation: A small device is placed under the skin that delivers electrical impulses to the sacral nerve, which controls bladder function. This procedure can help reduce symptoms of both urge and stress incontinence.

Diapers for Mixed incontinence

For those moments in which you won’t be able to make it to the bathroom despite your best efforts, Friends Adult Diapers can provide the comfort and peace of mind you need.

With over 2 decades of experience in the diaper manufacturing business, Friends Adult Diapers have something to meet all your incontinence needs. Friends Adult Diapers:

  • Provide superior absorption for up to 16 hours.

  • Are made to fit YOUR body perfectly to prevent leaks, spills and uncomfortable bunching.

  • Have side leak guards to prevent leakage from the sides.

  • Are free of chlorine, latex, toxins and harmful chemical fragrances.

  • Are available in a number of different variants including overnight, pant-style and tape-style diapers and a number of sizes including S, M, L, XL and XXL.

    With Friends Adult Diapers aapko Azadi Mubarak!

    Hope this blog helped put mixed incontinence into perspective for you. Although no treatment can completely cure mixed incontinence, we can assure you that a combination of multiple treatments can bring you relief that you thought you lost forever.

    What are common causes of mixed incontinence?

    Mixed incontinence can be caused by a combination of factors, including weakened pelvic floor muscles, nerve damage, hormonal changes, bladder irritation, and structural problems such as a prolapsed bladder or uterus.

    How do you treat mixed incontinence?

    Treatment for mixed incontinence may involve a combination of behavioral therapies, such as bladder training and pelvic floor exercises, and medical therapies, such as medications or surgery. Your doctor can help determine the best treatment approach based on your specific needs and medical history.

    What are the first signs of mixed incontinence?

    The first signs of mixed incontinence may include a combination of symptoms associated with both stress and urge incontinence. These may include leakage of urine during physical activity, such as coughing or sneezing, as well as a sudden and strong urge to urinate that may be difficult to control.

    Which type of patient frequently has mixed incontinence?

    Mixed incontinence can occur in both men and women, but it is more common in women. Women who have had multiple pregnancies and vaginal deliveries, as well as women who are postmenopausal, are at a higher risk of developing mixed incontinence.

    Can mixed urinary incontinence be cured?

    Mixed urinary incontinence may not be curable, but it can be managed through a combination of behavioral and medical therapies. Treatment can help improve symptoms and quality of life for those living with mixed incontinence.