Mixed Incontinence Masked as Stress Induced Urgency Urinary Incontinence

To understand variation in expression and the temporal relation of bladder control episodes among women with mixed urinary incontinence (MUI).

A random sample of women ≥40 years with MUI from the General Longitudinal Overactive Bladder Evaluation - UI was recruited into a digital daily diary study using a smart phone application. When a bladder control event occurred, women were instructed to answer episode specific questions. Episodes were defined as urgency, UI with and UI without urgency. Women and episodes were compared by type of activity preceding each episode. UI episodes were further defined as stress UI (SUI), urgency UI (UUI), stress induced UUI, and other. Chi-square and Wilcoxon tests were used for categorical and continuous variables, respectively.

A total of 35 of 40 women (mean age = 65.5) provided complete 30-day diary data. Of the 950 bladder control episodes reported, 25% were urgency only, 55% were UI with urgency, and 19% were UI without urgency. Of the UI episodes without urgency, 82% occurred after a stress activity (e.g., coughing or sneezing). Notably, a stress activity also occurred just before 52.5% of the UUI episodes, P<0.001. Twenty-four (69%) reported at least one episode of stress induced UUI which was the most prevalent UI subtype episode (29%) followed by UUI (27%) and SUI (16%). Mean number of daily episodes ranged between 1 and 2 across all groups.

Women with MUI express a heterogeneous set of bladder control episodes with stress induced UUI being the dominant type.

The Journal of urology. 2016 May 05 [Epub ahead of print]

Vatché A Minassian, Xiaowei S Yan, James Pitcavage, Walter F Stewart

Brigham and Women's Hospital, Boston, MA. Electronic address: ., Sutter Health System, CA., Geisinger Health System, Danville, PA., Sutter Health System, CA.