Journal of Health Science Research

Open Access Open Access  Restricted Access Subscription Access

Mixed Urinary Incontinence (MUI) in Women: From Evidence to Clinical Practice


Affiliations
1 Department of Amraze Niswan wa Qabalat (Gynecology and Obstetrics), National Institute of Unani Medicine, PG Institute of Research, Bengaluru – 560091, Karnataka, India
2 Kegalle Ayurvedic Hospital, Sri Lanka
3 Department of Pharmacy, National Institute of Unani Medicine, Bengaluru – 560091, Karnataka, India
4 Department of Amraze Niswan wa Qabalat (Gynecology and Obstetrics), National Institute of Unani Medicine, Bengaluru – 560091, Karnataka
 

Mixed Urinary Incontinence (MUI) in women is an important disease that is under-treated and under-reported with high prevalence of 33% of all cases of incontinence. It significantly impairs women’s quality of life. MUI usually represent with more severe symptoms and are more likely to present for the treatment as per the recent studies. The management not only includes the conventional but also the complementary and alternative medicine treatment incorporating details from evidence to clinical practice. Combinations of behavioral modification, pelvic floor physiotherapy, biofeedback, pharmacotherapy, anti-incontinence devices, and complementary therapies is useful to treat mixed symptoms. Some researches recommended the use of Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) and antimuscarinic drugs to treat MUI. Some studies showed that acupuncture is beneficial for MUI. The treatment with herbal medicine such as mace, Boswellia serrata and Cyperius were also effective in treating MUI symptoms.

Keywords

Antimuscarinic Drugs, Complementary and Alternative Medicine, Mixed Urinary Incontinence, Pelvic Floor Physiotherapy, "Quality of life"
User
Notifications
Font Size

  • Brown ET, Reynolds WS, Kaufman MR, Dmochowski RR. Advances in the treatment of urinary incontinence in women. Clinical Medicine Insights: Urology. 2015; 8:1–6. https://doi.org/10.4137/CMU.S13181

  • Charalambous S, Tranafylidis A. Impact of urinary incontinence on quality of life Pelviperineology. 2009; 28:51–3.

  • Schorge JO, Schaffer JI, Halvorson LM, Hoffman BE, Bradshaw KD, Cunningham FG. William’s Gynecology. China: Mc-Graw Hills Companies; 2008. p. 512.

  • Smith PP, Mc Crery RJ, Appell RA Current trends in the evaluation and management of female urinary incontinence. Canadian Medical Association Journal. 2006; 175(10):1233–40. https://doi.org/10.1503/cmaj.060034. PMid:17098954 PMCid:PMC1626507

  • Harvey MA, Kristjansson B, Griffith D, Versie E. The incontinence impact questionnaire and the urogenital distress inventory: A visit of their diagnosis. American Journal of Obstetrics and Gynecology. 2001; 185:25–31. https://doi.org/10.1067/mob.2001.116369. PMid:11483899

  • Chen SH. Differential diagnosis of urinary incontinence. Tzu Chi Medical Journal. 2007; 19(2):53–9.

  • Lin CC, Huang KH, Wu MP. Determining when to sling for mixed urinary incontinence? Incontinence & Pelvic Floor Dysfunction. 2009; 3(1):11–16.

  • Based on the Random House Dictionary, ©Random House, Inc.2016. [Internet]. [cited 2016 Feb 16]. Available from: www.dictionary.com/browse/unabridged.

  • Chapple C. Classification of mixed incontinence. European Urology Supplements. 2006; 5:837–41. https://doi.org/10.1016/j.eursup.2006.07.006

  • Price N, Dawood R, Jackson SR. Pelvic floor exercise for urinary incontinence: A syst literature rev. Maturitas. 2010; 67(4):309–15. https://doi.org/10.1016/j.maturitas.2010.08.004. PMid:20828949

  • Porena M, Costantini E, Lazzeri M. Mixed incontinence: How best to manage it? Current Bladder Dysfunction. 2013; 8:7–12. https://doi.org/10.1007/s11884-012-0161-8. PMid:23396610 PMCid:PMC3563944

  • Brubaker L, Lukacz ES, Burgio k, Zimmern PH, Norton P, Leng W, et al. Mixed incontinence: Comparing definitions in non-surgical patients. Neurourology and Urodynamics. 2011; 30(1):45–51. https://doi.org/10.1002/nau.20922. PMid:21181960 PMCid:PMC3682677

  • Brubaker L, Stoddard A, Richter H, Zimmern, PH Moalli P, Kraus SR, et al . Mixed incontinence: Comparing definitions in women having stress incontinence Surgery. Neurourology and Urodynamics. 2009; 28(4):268–73. https://doi.org/10.1002/nau.20698. PMid:19274758 PMCid:PMC2702259

  • Gomelsky A, Dmochowski RR. Treatment of mixed urinary incontinence. Central European Journal of Urology. 2011; 64(3):120–6. https://doi.org/10.5173/ceju.2011.03.art2. PMid:24578878 PMCid:PMC3921730

  • Caetano A. Incontinence: Physical activity as a supporting preventive approach [Internet]. [cited 2015 Apr 08]. Available from: www.intechopen.com.

  • Subak LL, Holly E. Richter HE, Hunskaar S. Obesity and urinary incontinence: Epidemiology and clinical research update. Journal of Urology. 2009; 182(6Suppl):S2–S7. https://doi.org/10.1016/j.juro.2009.08.071

  • Brubaker L, Moalli P, Richter H E, Albod M, Sirls L, Chaif T, et al. Challenges in designing a pragmatic clinical trial: The mixed incontinence - Medical or surgical approach (MIMOSA) trial experience. Clinical Trial. 2009; 6(4):355–64. https://doi.org/10.1177/1740774509339239. PMid:19625327 PMCid:PMC2875993

  • Frick AC, Huang AJ, Eeden SKVD, Knight S K, Creasman JM, Yang J, et al. Mixed urinary incontinence: Greater impact on quality of life. Journal of Urology. 2009; 182(2):596–600.

  • https://doi.org/10.1016/j.juro.2009.04.005. PMid:19535107 PMCid:PMC2746250

  • Kabir al-Din M. Iksir-i-A’zam. New Delhi: Idarae Kitabus Shifa. YNM. p.734–35.

  • Foldspang A, Mommsen S, Djurhuus JC. Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth and obstetrics techniques. American Journal of Public Health. 1999; 89:209–12. https://doi.org/10.2105/ AJPH.89.2.209. PMid:9949751 PMCid:PMC1508519

  • Foldspang A, Mommsen S, Lam GW, Elving L. Parity as a correlate of adult female urinary incontinence prevalence. Journal of Epidemiology and Community Health. 1992; 46: 595–600.

  • https://doi.org/10.1136/jech.46.6.595. PMid:1494074 PMCid:PMC1059675

  • Grodstein F, Fretts R, Lifford K, Resnick N, Curhan G. Association of age, race and obstetric history with urinary symptoms among women in the Nurses Health study. American Journal of Obstetrics and Gynecology. 2003; 189(2):428–34. https://doi.org/10.1067/S00029378(03)00361-2

  • Bieber EJ, Sanfilippo JS, Horowitz IR. Clinical Gynecology. Canada: Churchill Livingstone Elsevier; 2006. p. 341–3.

  • Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. New Delhi: Saunders; 2004. p.111–12.

  • Mc Kertich K. Urinary incontinence Assessment in women: Stress, urge or both? Australian Family Physician. 2008; 37(3):112–7

  • Arya LA, Heidi H, Cory L, Segal S, Northington GM. Construct validity of a questionnaire to measure the type of fluid intake and type of urinary incontinence. Neurourology and Urodynamics. 2001; 30(8):1597–1602. https://doi.org/10.1002/nau.21091. PMid:21462242 PMCid:PMC3383775

  • Wren PA, Janz NK, Brubaker L, Fitzgerald MP, Weber AM, Laporte FB, et al. Reliability of health related quality of life measures 1 year after surgical procedures for pelvic floor disorders. American Journal of Obstetrics and Gynecology. 2005; 192:780–8. https://doi.org/10.1016/j.ajog.2004.10.603. PMid:15746672

  • Sandvik H, Seim A, Vanvik A, Hunskaar S. A severity Index for epidemiological surveys of female urinary incontinence: Comparison with 48-hour pad-weighing Tests. Neurourology and Urodynamics. 2000; 19:137–45. https://doi.org/10.1002/(SICI)1520-6777(2000)19:2<137::AIDNAU4> 3.0.CO;2-G

  • Labrie J, Berghmans BLCM, Fischer K, Milani AL, Wijk I, Smalbraak DJC, et al. Surgery versus physiotherapy for stress urinary incontinence. New England Journal of Medicine. 2013; 369:1124–33. https://doi.org/10.1056/NEJMoa1210627. PMid:24047061

  • Hebbar S, Pandey H, Chawla A. Understanding King’s Health Questionnaire (KHQ) in assessment of female urinary incontinence. International Journal of Research in Medical Sciences. 2015 Mar; 3(3):531–8. https://doi.org/10.5455/2320-6012.ijrms20150301

  • Souza CC, Rodrigues AM, Ferreira CE, Fonseca ES, di Bella ZI, Girão MJ, Sartori MG, Castro RA. Portuguese validation of the urinary incontinence-specific quality-of-life Instrument: I-QOL. International Urogynecology Journal. 2009 Oct 1; 20(10):1183–9. https://doi.org/10.1007/s00192009-0916-8. PMid:19506791

  • Haywood KL, Garatt AM, Lall R, Smith JF, Lamb SE. Quality of Life Research. 2008; 17(3):475–83. https://doi.org/10.1007/s11136-008-9311-z. PMid:18274881

  • Karantanis E, Fynes M, Moore KH, Stanton SL.Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction. 2004 ;15(2):111–6. https://doi.org/10.1007/s00192-004-1123-2. PMid:15014938

  • Hajebrahimi S, Nourizadeh D, Hamedani R, Pezeshki MZ. Validity and reliability of the international consultation on incontinence questionnaire-urinary incontinence short form and its correlation with urodynamic findings. Urology Journal. 2012 Fall; 9(4):685–90.

  • Cam C, Sakalli M, Ay P, Cam M, Karateke A. Validation of the short forms of the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6) in a Turkish population. Neurourology and Urodynamics. 2007; 26:129 –33. https://doi.org/10.1002/nau.20292. PMid:17083117

  • ‘t Hoen LA, Utomo E, Anneke B. Steensma A B, Blok B F M, Korfage IJ. The pelvic organ prolapse/urinary incontinence sexual. Questionnaire (PISQ-12): validation of the Dutch version. International Urogynecology Journal. 2015; 26(9):1293–303. https://doi.org/10.1007/s00192-0152692-y. PMid:25963057 PMCid:PMC4545192

  • Hewison A, McCaughan D, Watt I. An evaluative review of questionnaires recommended for the assessment of quality of life and symptom severity in women with urinary incontinence. Journal of Clinical Nursing. 2014; 23(21–22):2998–3011. https://doi.org/10.1111/jocn.12503. PMid:24372609

  • Bradley CS, Rahin DD, Nygaard IE, Barber MD, Nager CW, Kenton KS et al. The Questionnaire for Urinary Incontinence Diagnosis (QUID): Validity and responsiveness to change in women undergoing non-surgical therapies for treatment of stress predominant urinary incontinence. Neurourology and Urodynamics. 2010; 29(5):727–34. https://doi.org/10.1002/ nau.20818. PMid:19787711 PMCid:PMC2891326

  • Jain P, Jirschele K, Botros SM, Latthe PM. Effectiveness of midurethral slings in mixed urinary incontinence: A systematic review and meta-analysis. International Urogynecology. 2011; 22(8):923–32. https://doi.org/10.1007/s00192-011-1406-3. PMid:21455757

  • Moquin B, Blackman MR, Mitty E, Flores S. Complementary and Alternative Medicine (CAM). Geriatric Nursing. 2009; 30(3):196–203. https://doi.org/10.1016/j.gerinurse.2009.03.002. PMid:19520231

  • Najeeya AG, Sultana A. Efficacy of mace (Arils of Myristica fragnans Houtt) plus PFMT on symptoms in mixed urinary incontinence: a randomized placebo-controlled trial. Integrative Medicine Research. 2018; 7:307–15. https://doi.org/10.1016/j.imr.2018.10.001. PMid:30519527 PMCid:PMC6260249

  • Padmaja AR, Sultana A, Rahman K, Sumana N. Effectiveness of Cyperus scariosus and Boswellia serrata on quality-of-life in women with stress urinary incontinence assessed with International Consultation on Incontinence Questionnaire-Short Form. Journal of Experimental and Integrative Medicine. 2014; 4(3):1–8. https://doi.org/10.5455/jeim.240614.or.107

  • Padmaja AR, Sultana A, Rahman K, Sumana N. Efficacy of Boswellia serrata L. and Cyperus scariosus L. plus pelvic floor muscle training in stress incontinence in women of reproductive age. Complementary Therapies in Clinical Practice. 2014; 20:230–6. https://doi.org/10.1016/j.ctcp.2014.08.003. PMid:25225151

  • Sultana A, Padmaja A, Najeeya AGF. Assessment of temperament in women with stress urinary incontinence: An observational study. Medical Journal of Islamic World Academy of Sciences. 2016; 24(2):33–9. https://doi.org/10.5505/ias.2016.24392

  • Liu B, Liu Y, Qin Z, Zhou K, Xu H, He L, et al. Electroacupuncture versus pelvic floor muscle training plus solifenacin for women with mixed urinary incontinence: A Randomized Noninferiority Trial Mayo Clin Proc. 2019; 94(1):54–65. https://doi.org/10.1016/j.mayocp.2018.07.021. PMid:30611454


Abstract Views: 495

PDF Views: 108




  • Mixed Urinary Incontinence (MUI) in Women: From Evidence to Clinical Practice

Abstract Views: 495  |  PDF Views: 108

Authors

Arshiya Sultana
Department of Amraze Niswan wa Qabalat (Gynecology and Obstetrics), National Institute of Unani Medicine, PG Institute of Research, Bengaluru – 560091, Karnataka, India
A. G. F. Najeeya
Kegalle Ayurvedic Hospital, Sri Lanka
Khaleequr Rahman
Department of Pharmacy, National Institute of Unani Medicine, Bengaluru – 560091, Karnataka, India
Rushda Saeedi
Department of Amraze Niswan wa Qabalat (Gynecology and Obstetrics), National Institute of Unani Medicine, Bengaluru – 560091, Karnataka
Marhaba Khanam
Department of Amraze Niswan wa Qabalat (Gynecology and Obstetrics), National Institute of Unani Medicine, Bengaluru – 560091, Karnataka

Abstract


Mixed Urinary Incontinence (MUI) in women is an important disease that is under-treated and under-reported with high prevalence of 33% of all cases of incontinence. It significantly impairs women’s quality of life. MUI usually represent with more severe symptoms and are more likely to present for the treatment as per the recent studies. The management not only includes the conventional but also the complementary and alternative medicine treatment incorporating details from evidence to clinical practice. Combinations of behavioral modification, pelvic floor physiotherapy, biofeedback, pharmacotherapy, anti-incontinence devices, and complementary therapies is useful to treat mixed symptoms. Some researches recommended the use of Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) and antimuscarinic drugs to treat MUI. Some studies showed that acupuncture is beneficial for MUI. The treatment with herbal medicine such as mace, Boswellia serrata and Cyperius were also effective in treating MUI symptoms.

Keywords


Antimuscarinic Drugs, Complementary and Alternative Medicine, Mixed Urinary Incontinence, Pelvic Floor Physiotherapy, "Quality of life"

References





DOI: https://doi.org/10.18311/jhsr%2F2020%2F25044