Advice & Support
Living with Incontinence

Mixed Incontinence

You may already have read about the different types of incontinence, most notably stress incontinence and urge incontinence. And if you have symptoms of both, you’re not alone.
Published by Jane Granger
Mixed Incontinence

What is Mixed Incontinence

As the name suggests, Mixed Incontinence is the term used for incontinence caused by multiple underlying issues.

Most typically, it’s a combination of:

  • A weakened pelvic floor muscle
  • Changes that cause the muscle walls of the bladder to contract more than they should, inducing a sudden and urgent need to urinate, known as urge incontinence.

You may also experience leakage when you’re asleep, drink a small amount of water, when you touch water or hear it running.

Mixed Incontinence mostly affects older women.



What are the symptoms of Mixed Incontinence?

Symptoms mirror those of stress and urge incontinence combined.

For stress, the pelvic floor muscle fails to hold urine in when under pressure from a laugh, cough or sneeze, lifting a heavy weight or participating in high impact activity and exercise. If in these situations, you involuntarily leak urine, that’s stress incontinence.

Urge incontinence is the sudden, urgent and uncontrollable need to pass urine. If it results in involuntary leakage, then that’s considered incontinence.

Mixed Incontinence is when both sets of symptoms are present. The balance may vary, for example, you may experience stress incontinence more frequently than urge, but regardless, if you have some of both then, by definition, you have Mixed Incontinence.

What are the causes of Mixed Incontinence?

Again, the causes mirror the separate conditions.

Stress incontinence is the result of a weakened pelvic floor muscle. That’s the sling of muscle that runs from the pubic bone to the tailbone and supports your bladder, bowel and reproductive organs. The muscles can be damaged during pregnancy and childbirth, but can go unnoticed until menopause.

Other lifestyle and health conditions can also contribute to the weakening of the pelvic floor muscle, including:

  • Obesity, which puts undue weight and stress on the pelvic floor, weakening it over time
  • Constipation. Straining can damage the muscle.
  • Smoking. It’s not smoking itself, but the cough that accompanies it that strains and weakens the pelvic floor
  • Menopause. With the decrease in estrogen levels, a reduction in muscle mass can occur if proactive steps, specifically exercise, aren’t taken


Urge Incontinence can also be triggered by a decline in estrogen around menopause, causing the bladder to contract more than it should.

You can read more about the effect of hormones on female incontinence on American site, The Simon Foundation for Continence.

Infection, usually a Urinary Tract Infection (UTI) is a common cause of urge incontinence, but can be quickly resolved with a trip to the doctor for confirmation and antibiotics.

Another cause of Urge Incontinence is nerve damage, which may have occurred during childbirth, especially vaginal births where instruments were required to deliver the baby. Diseases such as Parkinson’s, multiple sclerosis, and diabetes, spinal cord damage, pelvic surgery and neurological conditions including anxiety, can all have an impact on the control of the bladder muscles.

It’s a good idea to keep track of what’s been happening before your appointment, as the types of questions you’re likely to be asked are:

  • Do you get much notice when you get the urge to go?
  • Can you hang on – at all, or just little?
  • Do you have a burning sensation when you pass urine? (Often a sign of a UTI)
  • How often are you leaking?
  • What are you usually doing when it happens?
  • You may also be asked about your fluid intake and other lifestyle habits, as well as surgeries, injuries and details of any childbearing



You may then be asked to take a stress test (like coughing), undergo a neurological examination to determine if there’s nerve damage, have a test done to measure any urine left in the bladder after voiding or undertake an ultrasound to view internal organs.

Any recommended procedures should be discussed directly with your doctor.


How is Mixed Incontinence treated?

A combination of remedies may be recommended to address the various causes, including

  • Pelvic floor exercises to strengthen the muscle and improve the ability to ‘hold on’
  • Bladder retraining
  • Lifestyle changes, such as losing weight, eating more fibre and drinking more water, quitting smoking
  • Medication to calm the bladder muscle spasms. There are several available, including Botox
  • Surgery and other procedures that physically address the cause


How to manage in the meantime
While you seek treatment or if exercise and bladder retraining is underway, you may find an absorbent product specifically designed to handle the thin, fast flow caused by a bladder contraction and a weak pelvic floor practical.

Take advantage of TENA’s Free Samples to find which product and level of absorbency best suits your requirements. You can order up to three free samples at a time.

And again, if you are suffering from any symptoms associated with Mixed Incontinence, you must see your doctor.




Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.