How is mixed urinary incontinence typically managed?

• A. Treat only stress symptoms
• B. Do not treat
• C. Address the predominant symptom first (urge or stress) and add combination therapies to treat both components as needed
• D. Treat only urge symptoms

Answer: (C)

Mixed urinary incontinence involves two mechanisms: urgency incontinence and stress incontinence. Because both components can contribute differently to leaks, the best approach is to start by addressing the symptom that is most bothersome or predominant, then add therapies to tackle the other component as needed. This strategy often yields the quickest meaningful improvement and provides a clear plan to escalate care if the second symptom persists. If urgency is dominant, you’d begin with bladder-focused strategies such as bladder training and pelvic floor rehabilitation, plus medications that calm the bladder (like a beta-3 agonist or an antimuscarinic). If stress dominates, focus on pelvic floor strengthening and related options (and consider other supportive measures or procedures for the stress component). When both parts are significant, combining treatments to cover both components typically offers the best overall control.