Mixed urinary incontinence—time to uncouple urgency from stress?

摘要: Introduction “Mixed incontinence” is defined as a combination of stress and urge symptoms. Over time, it has morphed into single entity, encompassing etiology treatment. My perspectives are: (a) Stress incontinence (SI) (UI) are different symptoms with often anatomical causation so should be treated separately; (b) It illogical to group urgency SI. Urgency may also associated frequency, nocturia, abnormal emptying pelvic pain in patients no SI (“posterior fornix syndrome”); (c) There growing evidence that cured by surgical correction cystocele and/or apical prolapse up 80% who do not have In this context, sensory urgency, urodynamic detrusor overactivity all hypothesized manifestations prematurely activated micturition reflex, caused lax vagina’s inability support bladder base stretch receptors. This statement can tested simple clinical test, “simulated operations”, whereby digitally supporting turn the midurethra, posterior vaginal cause significant decrease felt patient.