Mixed incontinence: definitions, outcomes, and interventions.

PURPOSE OF REVIEW: Mixed incontinence remains a problematic issue in clinical practice. Interventions designed to benefit one of the contributory symptoms often do no benefit the other constituent symptom. Recent evolution in the taxonomy of mixed incontinence as well as the increased reporting of standardized results has produced a better understanding of the response of this entity to clinical interventions.

RECENT FINDINGS: Three main areas of development have occurred in the analysis of mixed incontinence. The advancements in definitional and taxonomic changes have clarified the concept and presentation of mixed incontinence. In light of these changes, results reported from pharmacologic or surgical interventions have improved. Several new studies have demonstrated the efficacy of these interventions in selected groups of patients using either pharmacologic or operative modalities.

SUMMARY: In well selected and symptomatically characterized patients, therapy directed at mixed incontinence can provide efficacious results. The implications of these positive outcomes suggest that therapy founded on appropriate symptomatic appraisal can produce generally salubrious outcomes. These outcomes must, however, be assessed with tools that allow adequate differentiation of symptomatic changes including methods that delineate not only cure but also symptom improvement.