Mixed Urinary Incontinence Treatment Overview

When to see a healthcare provider

If at-home treatments haven’t improved symptoms of mixed urinary incontinence after 6 weeks, see a healthcare provider.

Getting diagnosed

Providers diagnose mixed urinary incontinence based on your symptoms, a physical exam, and tests including:

• Urinalysis to check the urine for a bacterial infection and other abnormalities.
• Ultrasound to look at organs like the bladder and kidneys.
• Cystoscopy or urethroscopy to look inside your bladder and urethra.
• Post-void residual urine assessment. This measures how thoroughly your bladder empties itself.
• Cough stress test. After filling your bladder, your provider will ask you to cough to see if the pressure it creates makes you leak urine.

You may also be asked to keep a urinary diary so your provider can see how much you drink and the amount of urine you produce.

What to expect from your doctor visit

• Your provider may recommend biofeedback to help you learn to control and strengthen the bladder muscles.
• Electrostimulation. This therapy is helpful for people who cannot work their pelvic floor muscles. Electrical muscle stimulation causes the muscles to contract, which strengthens them.
• Injecting collagen into the tissue surrounding the urethra may be recommended to treat stress incontinence.
• Your provider may prescribe medications that calm overactive bladder muscles, like oxybutynin (Ditropan) or tolterodine (Detrol). Injecting Botox into the bladder can also help control overactivity.
• If leakage is an issue, your provider may suggest urethral inserts. These tampon-like devices act like a plug to prevent leaks.
• A small device called a pessary treats incontinence by supporting the walls of the urethra and bladder.
• Rarely, surgery is needed. A surgeon places a thin strip of mesh under the urethra to prevent urine from leaking.

Prescription medications for mixed urinary incontinence

• Oxybutynin (Ditropan)
• Tolterodine (Detrol)
• Darifenacin (Enablex)

Types of providers who treat mixed urinary incontinence

• A primary care provider can treat mild to moderate symptoms.
• An obstetrician/gynecologist specializes in female reproductive health and can diagnose and treat mixed urinary incontinence disorder in women.
• If your symptoms are severe or you need surgery, you may be referred to a urologist.

Treating mixed urinary incontinence at home

Symptoms of mixed urinary care incontinence—sudden urges to urinate, recurring problem of leaking urine, waking up regularly during the night to urinate—can sometimes be treated at home.

• Going to the bathroom at regularly scheduled times can help lengthen the amount of time between bathroom visits. By urinating less often, the bladder muscles get stronger, controlling leaking and decreasing urges to run to the bathroom.
• Doing pelvic muscle exercises, called Kegels, can reduce symptoms. These are the muscles you use to retain and release urine. Squeezing and relaxing these muscles makes them stronger, preventing leaks and sudden urges to urinate.

Wellness and prevention

• Limit foods and drinks that can irritate the bladder, like citrus fruits (which are acidic), artificial sweeteners, spicy foods, alcohol, coffee, and chocolate.
• Drink small amounts of fluid at a time.
• Stop drinking fluids 2 hours before you go to bed to avoid urinating frequently during the night.
• Lose weight if necessary. Being overweight or obese increases pressure on the bladder.