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    INCONTINENCE

    Mixed Incontinence: Causes, Symptoms and Treatments

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    Urinary incontinence occurs when urine is involuntarily leaked from the bladder. This can range from little leaks to full bladder voids. There are many different types of incontinence and one of them is mixed urinary incontinence. While it can be an unpleasant experience, mixed incontinence doesn’t need to rule your life.

    What is Mixed Incontinence?

    Incontinence comes in three main types: stress, urge and overflow. If you have a combination of any of two of these types of urinary incontinence, this is known as mixed urinary incontinence.

    Stress Urinary Incontinence is the result of a weakened pelvic floor–the system of muscles, ligaments and nerves that supports your bladder, uterus and anus. Your pelvic floor muscles helps control the urinary sphincter, which is responsible for closing off the bladder and regulating urine flow. The pelvic floor can become weakened by things like childbirth or being overweight. As a result, urine leaks out when pressure or stress is exerted on the pelvic floor during everyday activities like sneezing, coughing, laughing or exercise.

    Illustration of stress incontinence

    You know the expression, “I laughed so hard I peed?” It just goes to show you’re not the only one out there!

    Urge urinary incontinence, also known as overactive bladder, is the result of nerve or muscle damage in the bladder tissue. This causes involuntary spasms in the bladder that create a sudden and intense urge to urinate. You may or may not make it to the toilet on time. You may even feel a strong urge to go when there is no urine in your bladder.

    Illustration of urge incontinence

    The most common type of mixed incontinence among women is a combination of stress and urge incontinence. Many women experience incontinence. In fact, more than you may think. Some 1 in 3 women between over the age of 35 are grappling with some form of incontinence. So, you’re in good company.

    Overflow urinary incontinence is the result of a bladder that cannot fully empty due to an obstruction. The blockage or obstruction can could be the result of a tumor, polyp, urinary stone or muscle weakness. Pressure from an overly full bladder creates a constant dribble of urine, even though you may not feel the urge to go. Overflow incontinence is the only type of incontinence more common in men than in women.

    Illustration of overflow incontinence

    Mixed Incontinence Symptoms

    Because mixed incontinence is typically a combination of stress and urge incontinence, you may experience symptoms of both types.

    Stress incontinence symptoms include:

    The main symptom of stress incontinence is leaking little spurts of urine as a result of everyday activities such as:

    • Laughing
    • Sneezing
    • Coughing
    • Exercise
    • Lifting objects or bending over
    • Standing up or getting out of the car
    • Sex

    Urge incontinence symptoms include:

    • Increased urination frequency more than 8 times a day
    • Waking up in the middle of the night 2 times or more to urinate
    • Sudden, intense urges to urinate, whether or not your bladder is full
    • Urinary urges that come on so strong that you may or may not be able to make it to the toilet

    If you experience a mix of symptoms from these two lists, you likely have mixed incontinence.

    Risk Factors and Causes of Mixed Incontinence

    Just like mixed incontinence shares symptoms with urge and stress incontinence, it may be caused by factors from either type as well.

    Stress incontinence is caused by a weakened pelvic floor, such that everyday activities that put pressure on the pelvic floor cause a small amount of urine to leak from the bladder. Common life events like pregnancy, childbirth and being overweight weaken the pelvic floor so that it no longer supports the bladder properly. Stress incontinence has nothing to do with experiencing emotional stress in your life.

    Urge incontinence is caused by damage to the nerves of the bladder, the nervous system or to the bladder tissue itself. This is typically a result of previous pelvic surgery, such as a C-section, or a neurological disease such as Parkinson’s or multiple sclerosis. Urinary tract infections (UTIs) can cause temporary urge incontinence, but this most often resolves itself as soon as the infection clears up.

    Risk factors such as thyroid problems, untreated diabetes, stroke, smoking and even certain medications can worsen symptoms of incontinence.

    Which Type of Urinary Incontinence Do You Have?

    Need help deciding which type of urinary incontinence you may have? Start by answering these questions:

    1. Do you pee when you laugh, cough or sneeze?
      How about when you’re running, exercising or sometimes when you’re just walking at a quick pace? If you experience bladder leaks during pressure-induced activities, like chronic coughing, sneezing, laughing, exercising or even sex, you may be experiencing the symptoms of stress incontinence.

    2. Do you feel like you randomly lose control?
      All of a sudden, out of nowhere, you gotta go! Many times, you don’t make it to the restroom fast enough, and the bladder leak has already happened.. Sound familiar?
      If you’re the “uh oh, gotta go!” kind of gal, it’s very possible you have urge incontinence. It’s probably a good idea to talk to your doctor if you’re experiencing this type of incontinence.

    3. Can’t decide if you have stress or urge incontinence?
      You very well may have both. Mixed incontinence is a combination of incontinence symptoms and may be caused by a variety of issues, too. An exam and more questioning by your doctor can help better understand the problem and possible solutions.

    Mixed Incontinence Treatments and Remedies

    Living in fear of a bladder leak is no fun. It is very easy to let bladder concerns dominate your day-to-day thoughts, and ultimately, your life. However, this need not be the case. Far from it! There are many products and tools at your disposal to use as mixed incontinence treatments and to keep living life as normal. Adopting the proper treatment and management plans will put you on the road to success. Mixed incontinence treatments draw on treatments for both stress and urge incontinence.

    Here are some tools to put in your mixed incontinence treatment arsenal:

    • Adopt a Bathroom Schedule
      Maintaining a bathroom schedule can help ease some of the urgency of urge incontinence. Start out by urinating once an hour, whether or not you have the urge to go. Once you feel comfortable with this schedule, start increasing the time between bathroom visits. Training your bladder in this way can help strengthen your bladder tissue, as well as bring a level of predictability to your bathroom needs.

    • Change Your Diet
      Avoid foods that make your urine more acidic, as acid will aggravate an already sensitive bladder. This means ditching caffeine and saying no to alcohol. Foods like citrus, chocolate and spicy foods are also bladder irritants. It’s best to avoid them.

    • Shed Some Weight
      Getting rid of extra pounds can go a long way in alleviating mixed incontinence symptoms. Excess weight puts pressure on the bladder muscles and pelvic floor, resulting in stress incontinence. Throw on some sneakers and fit in a few walks around the block for a straightforward mixed incontinence treatment.

    • Pelvic Floor Exercises
      You may know them as kegels. Just because you have a weakened pelvic floor doesn’t mean it needs to stay that way. The muscles of the pelvic floor can be strengthened just like any other muscle in the body by doing targeted exercises. Try squeezing the muscles you use hold in urine. Do so without clenching your behind. Squeeze and release 5 to 10 times in one session, alternating between long squeezes and short squeezes. Repeat this every day for best results. Just like with any physical exercise, results are seen over time. Practice makes perfect, so keep at it!

    • Drink Up!
      This one may seem counterintuitive. After all, if you have to urinate frequently, wouldn’t it make sense to drink less? The problem with that is that drinking less makes urine more concentrated, and therefore more acidic. And acid will irritate your bladder, making your mixed incontinence symptoms worse. So be sure to drink plenty of water. Be sure to take small sips throughout the day so as not to overwhelm your bladder with too much liquid.

    • Quit Smoking
      Cigarette smoke can aggravate your bladder muscles. Smokers’ cough can also trigger little leaks of urine. Living a healthy lifestyle can greatly improve symptoms of an overactive bladder!

    • Medication
      Talk to your doctor about whether taking a prescription drug to relax your bladder muscles is right for you.

    • Incontinence Liners, Pads and Underwear for Mixed Incontinence
      Specially designed incontinence liners and pads provide comfort and peace of mind for those moments in which you won’t be able to make it to the bathroom despite your best efforts. Not all liners and pads are created equal. Some are designed for dealing with incontinence, and others are not. Some women, reluctant to purchase incontinence products due to either stigma or inconvenience, wear period liners to address their incontinence. However, period liners are not designed to absorb urine, and may require very frequent changes as a result.

    Always Discreet liners and pads are designed differently– the super absorbent core quickly turns liquid to gel and neutralizes odors, leaving you worry-free to focus on doing what you love. Always Discreet liners and pads are thin, comfortable, and stay in place so you can go about your day confident and worry-free.

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