Mixed urinary symptoms: what are the urodynamic findings?

To define the urodynamic diagnoses of women with mixed urinary incontinence (MUI) symptoms.

Women with MUI symptoms were studied. They were divided into stress predominant MUI; urge predominant MUI; or equal severity of stress and urge MUI on the basis of the most severe symptom scored on the King's Health Questionnaire. The frequency of different urodynamic diagnoses for the all women with MUI and in each of the above groups was calculated.

Overall 3,338 women were studied. Of these 49% (1,626/3,338) reported MUI symptoms and were included. In this group 29% (464/1,626) had stress predominant MUI, 15% (248/1,626) had urge predominant MUI and 56% (912/1,626) had equal severity of urge and stress MUI. On urodynamics 42% (665/1,626) had pure urodynamic stress incontinence, 25% (414/1,626) had pure detrusor overactivity, 18% (299/1,626) had both detrusor overactivity and urodynamic stress incontinence and 15% (248/1,626) had normal urodynamic studies. In those with stress predominant MUI, 82% had urodynamic stress incontinence; in those with urge predominant MUI, 64% had detrusor overactivity. The urodynamic diagnoses were significantly different for the different balance of symptoms (P < 0.05, Chi-Square test). In women with equal severity of urge and stress incontinence, 46% had detrusor overactivity while 54% had urodynamic stress incontinence.

The relative severity of MUI symptoms from a symptom questionnaire significantly distinguishes between different urodynamic diagnoses. Women with urge predominant MUI are more likely to have detrusor overactivity while those with stress predominant MUI are more likely to have urodynamic stress incontinence.