Mixed urinary incontinence: Are there effective treatments?

Area of Science:

• Urology
• Gynecology
• Geriatrics

Background:

• Mixed urinary incontinence (MUI) involves both stress and urgency urinary incontinence (SUI and UUI) symptoms.
• Current treatment guidelines recommend addressing the predominant symptom first.
• This approach may lead to suboptimal management for patients with combined symptoms.

Purpose of the Study:

• To debate the availability of effective treatments for mixed urinary incontinence (MUI).
• To review standard and emerging treatments for SUI and UUI in the context of MUI.
• To assess how well current treatments meet the needs of patients with MUI.

Main Methods:

• Review of standard treatments including lifestyle changes, pelvic floor exercises, pharmacological agents, and surgery.
• Examination of emerging treatments, particularly novel pharmacological agents.
• Analysis of treatment guidelines and clinical trial criteria for SUI and UUI.

Main Results:

• Standard treatments for MUI often focus on the predominant symptom, with surgery being standard for SUI and pharmacological agents for UUI.
• Emerging pharmacological treatments primarily target UUI, frequently excluding patients with SUI or stress-predominant MUI from trials.
• This selective focus results in a gap in effective therapeutic options for many MUI patients.

Conclusions:

• Current standard and emerging treatments are insufficient for effectively managing mixed urinary incontinence (MUI).
• A need exists for treatments that address both stress and urgency components of MUI simultaneously.
• Development of agents with dual mechanisms of action is proposed as an ideal future direction.