The term mixed urinary incontinence, when defined for research purposes, is problematic and broadly inclusive; this analysis demonstrated that it is important to describe both subcomponents of mixed urinary incontinence.
The use of the term mixed urinary incontinence in women planning stress incontinence surgery should be replaced by quantification of both urge and stress incontinence.
Combining antimuscarinic drug therapy with supervised behavioral training did not improve the ability of women with urge predominant incontinence to discontinue medication and maintain improvements in urinary incontinence 8 months later.
The addition of behavioral training to drug therapy is of possible benefit for reducing incontinence frequency during active treatment; a higher proportion of patients in combined therapy achieved ?70% reduction of incontinence than in drug therapy alone at 10 weeks.
Combined therapy yielded better outcomes than drug therapy alone on patient satisfaction, patient-perceived improvement, and reducing other bladder symptoms.
In women with urge-predominant incontinence, urinary urgency scores decreased significantly with both drug therapy alone and combined drug + behavioral therapy.
Combined drug and behavioral therapy did not improve urgency more than drug alone, but did produce better outcomes on 24-hour voiding frequency.
Improvement in urgency was associated with greater baseline urgency and black ethnicity.
Improvement in voiding frequency was associated with combined treatment, higher baseline frequency, and lower baseline incontinence episode frequency.
The objective of this analysis was to determine whether participants in either arm of the BEDRI trial experienced reduction in the frequency of nocturia and/or nocturnal leakage episodes during treatment.
We analyzed urinary diary data relating to nocturia and nocturnal incontinence before and after 8 weeks of study treatment in the BEDRI trial. Chi-square tests assessed whether nocturia and nocturnal incontinence prevalence varied by treatment arm and paired t tests assessed the change in mean frequency of nocturia and nocturnal leakage.
Among 305 women, 210 (69%) had an average of at least one nocturia episode at baseline. There were small but statistically significant differences (p<0.001) in mean nocturia frequency and nocturnal incontinence frequency with both treatments after 8 weeks, but no significant difference between study treatment groups.
We concluded that among BEDRI participants, who had low levels of nocturia at baseline, neither study treatment had significant clinical impact on either nocturic frequency or nocturnal incontinence.
Fecal incontinence is common among women with urge incontinence (18% have urinary and fecal incontinence).
Significant impairments in quality of life are seen in women with fecal and urge urinary incontinence.
Factors affecting the pelvic floor, such as a prior vaginal delivery, posterior compartment pelvic organ prolapse, and increased body weight, may be associated with fecal incontinence in women with urge urinary incontinence.
A secondary analysis of subjects in the BE-DRI Trial
after controlling for group, only younger age was associated with short-term success of treatment for urge incontinence (OR 0.8, 95% CI: 0.66, 0.96)
at 6 months controlling for group and short-term outcome, only greater anterior vaginal wall prolapse was associated with successful drug discontinuation (POP-Q point Aa; OR 1.33, 95% CI: 1.03, 1.7)
this information might be used to promote realistic expectations when counseling patients on the benefits of medication and behavioral therapy for the treatment of urge urinary incontinence
General fluid instructions may contribute to the reduction in UUI symptoms for women taking anticholinergic medications, but additional individualized instructions along with other behavioral therapies did little to improve outcome further.
