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Mixed Incontinence: Causes, Symptoms and Treatments

Mixed Incontinence Causes, Symptoms and Treatments

Millions of Americans struggle with the ability to control urination. Leaking when you sneeze, cough, or even laugh can be extremely inconvenient. Studies have found that almost 6% of admissions in nursing homes are due to incontinence issues1

However, people sometimes fail to identify that different types of incontinence could be causing issues for them. Some people might experience minor leaks, while some end up with heavy bladder incontinence. 

Broadly, there are six typical types of incontinence — stress, urge, overflow, functional, total, and mixed.

In this article, we will shed some light on mixed incontinence and discuss important aspects of the condition.

What is mixed incontinence?

Research estimates that approximately 45% of women within the 30 to 90 year old age bracket deal with some type of incontinence. Of this group, half of these women undergo symptoms of mixed incontinence2

When you experience symptoms of two or more kinds of incontinence, it’s classified as a form of mixed incontinence. Typically, it is a mix of urge and stress incontinence. 

Stress Incontinence

In stress incontinence, activities and movements such as sneezing, coughing, and lifting exert pressure on the bladder or abdomen, causing urine to leak. Stress here refers to excessive physical stress, rather than emotional stress.

Urge Incontinence

Urge incontinence is when you experience a sudden need to urinate and leak involuntarily, regardless of which environment you are in. In such cases, the urinary bladder contracts when it should not, and urine leaks through the sphincter muscles responsible for keeping the bladder closed.

What causes mixed incontinence?

 Mixed incontinence, restroom sign

Since mixed incontinence is essentially a cross between urge and stress incontinence, it is caused by a combination of factors.

Stress incontinence is typically a result of weakness in the pelvic floor muscles that support the bladder.

Weakness in the muscles that control the release of urine is also a contributor. Urge incontinence usually happens when the muscles in the wall of the bladder contract too much.

The following factors commonly cause mixed incontinence:

  • Pregnancy and childbirth
  • Anxiety
  • Radiation or surgery to the prostate, vagina, or rectum
  • Constipation
  • Pelvis injury
  • Diabetes
  • Urinary tract infection (UTI)
  • Obesity
  • Parkinson’s disease
  • Conditions affecting the nervous system
  • Multiple sclerosis

What are the symptoms of mixed incontinence?

A. Urine leakage during:
    • Coughing
    • Lifting
    • Sneezing
    • Laughing
    • Exercising
    • Sexual activity
    B. Urine leakage after:
      • Drinking a small amount of water
      • Hearing water run
      • Sleeping
      • Touching water

      C. Sudden and intense urges to leak

      How is mixed incontinence diagnosed?

      Mixed incontinence

      If you feel like you may have some form of incontinence, keeping a diary can give better insights into your condition. In this diary, you should note down your bathroom habits, leakage, and a record of when you urinate.

      A doctor might even suggest you note the time and amount you urinate with the help of special devices. Recording fluid intake can also help doctors gain a better understanding.

      Besides the diary, the doctor may ask you a few questions about your symptoms, such as:

      • How often do you go to the bathroom?
      • Do you get frequent UTIs?
      • Do you leak before you get to the bathroom?
      • Do you have trouble starting or stopping the flow of urine?
      • Do you experience pain or burning during urination?
      • Do you leak during some specific activities?

      Physical Examination & Tests

      The doctor may perform certain tests and physical examinations to look for signs of damage to the nerves.

      • Bladder Stress Test

      It is performed to determine if you leak while coughing.

      • Urinalysis

      A sample of your urine is assessed in a lab for any abnormalities or infection.

      • Catheterization

      Once you urinate, the doctor uses a catheter to determine if more urine comes out. If so, it indicates that you are unable to properly empty your bladder.

      • Ultrasound

      An imaging test of the inner organs, such as the kidneys and bladder, is used to visualize the organs.

      • Urodynamic Testing

      This provides information about bladder contractions, urine flow, leakage, bladder pressure, and nerve signals.

      • Neurological Exam

      Allows the doctor to determine the presence of any nerve problems.

      • Cystoscopy

      Enables the doctor to look inside the urethra and bladder for any structural issues.

      What can you do to address mixed incontinence issues?

      Mixed Incontinence

      While mixed incontinence can be a frustrating experience, using the right products can help you manage your struggles more effectively.

      At Norton Hurley, you can find a multitude of absorbent products to make life with incontinence easier to cope with. Here are a few products that you can consider for dealing with mixed incontinence:

      1.    TENA Large Underpad

      Tena Large Underpad can be used by anyone with light bladder incontinence, irrespective of gender. It is also ideal for people with mobility impairments as a result of childbirth or surgeries. Patients in bariatric care can also benefit from these underpads.


      • Advanced technology wicks fluids away from the skin.
      • Highly absorbent core and a waterproof backsheet prevent leakage.
      • Locks in odor and moisture for a clean and healthy experience.
      • Quilted mat design offers relief and convenience for longer durations.
      • Large underpads that cover more surface and offer higher absorbency.
      • Soft and gentle interior lining prevents heat-trapping.
      • Better fluid dispersion and stability.

      2.    Tranquility Select Unisex Incontinence Pad

      Tranquility Select Pad

      The Select Unisex Incontinence Pad from Tranquility is meant for people dealing with light bladder incontinence. It is extremely thin and breathable, ensuring utmost comfort in all situations. Moreover, it is tested and certified to ensure it is suitable for people with delicate skin.


      • Anatomically shaped, rash-free, and cushioned for comfort.
      • Smooth and delicate top sheet avoids friction and keeps your skin dry.
      • Each pad is wrapped individually for hygiene and portability.
      • Adhesive strip ensures that the pad stays in place.
      • Highly absorbent slim core and additional length barrier prevent leakage.
      • Delicate elastics and uniform fluid diffusion channels direct fluids away from the skin.
      • Moisture-proof backing allows it to be used in any underwear.

      3.    Depend FIT-FLEX Pull Up Underwear

      The Fit-Flex Underwear from Depend is an excellent product, designed specifically for women. It offers maximum absorbency, making it ideal for those that deal with high urinary incontinence. It is very convenient and fits well like underwear.


      • Lotion-free and fragrance-free.
      • Form-fitting elastic ensures a discreet fit.
      • Super absorbent material locks away moisture and odor.
      • DryShield Technology prevents leakage and offers long-lasting dryness.
      • Ideal for postpartum use.
      • Extremely flexible and moves in sync with your body.
      • Tearaway seams provide ease in putting on and off.
      • Discreet packaging ensures privacy and security.
      • Ultra-soft fabric for maximum comfort.

      4.    Depend Real Fit Pull Up Underwear

      Depend Real Fit Underwear for Men

      The Depend Real Fit Underwear is a great choice for men struggling with heavy bladder incontinence. It has a bold and modern design that ensures complete discretion when worn under clothes.


      • Sleek, flexible, and comfortable with an underwear-like fit.
      • Made with soft cotton-like materials that stretch and glide with you.
      • Odorless and disposable product.
      • Lotion-free, fragrance-free, and latex-free.
      • Tailored leg elastics help prevent leakage.
      • Discreet packaging for privacy.
      • Secure fit waistband keeps the product in place.


      Why would someone suddenly become incontinent?

      When the bladder muscles abruptly contract and the sphincter muscles aren't strong enough to pinch the urethra shut, incontinence may occur. You may be unable to manage a sudden, intense desire to urinate as a result of this. Urine leakage may be induced by the pressure created by laughing, sneezing, or exercising.

      Is bowel incontinence a normal part of aging?

      Although it is not a natural component of aging, you may be more susceptible to the disease as you become older. The pelvic region must be functional in order to sustain bowel control. Incontinence may develop if this is not done. Normal bowel control and function may be lost due to injury or sickness.

      Can dehydration cause bladder incontinence?

      If you don't drink enough water, dehydration may cause your urine to become extremely concentrated. This strong salt solution may irritate your bladder and worsen incontinence. Bladder irritation may be caused by carbonated beverages, artificial sweeteners, tea, and coffee use (with or without caffeine).

      Does stress cause incontinence?

      When physical activity or movement, such as coughing, laughing, sneezing, jogging, or heavy lifting, exerts pressure (stress) on your bladder, it causes you to leak urine. Stress incontinence has nothing to do with mental stress.


      Incontinence may not create a life and death condition, but it also should not be ignored. Timely treatment can make it easier for you to manage incontinence in the best way possible.

      Studies have found that pelvic floor muscle training is a great way of controlling mixed incontinence in women3.

      Mixed incontinence can be embarrassing, and even lead to social isolation. So, if you or someone you know is dealing with symptoms of mixed incontinence, check out the range of efficient products at Norton Hurley.


      1. Harris S, Riggs J. Mixed Urinary Incontinence. Updated 2020 Aug 27]. In: StatPearls Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
      2. Porena, M., Costantini, E. & Lazzeri, M. Mixed Incontinence: How Best to Manage It?. Curr Bladder Dysfunct Rep 8, 7–12 (2013)
      3. Dumoulin C, Cacciari LP, Hay‐Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2018, Issue 10.

      Disclaimer: The information presented here is purely for educational purposes and should not be used in place of the advice of your doctor or physician.