Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
What Is Mixed Urinary Incontinence?
Mixed urinary incontinence means you experience symptoms of both stress incontinence and urge incontinence. You might leak when you cough, sneeze, or exercise (stress component) and also experience sudden, intense urges with leaking on the way to the bathroom (urge component). It’s one of the most common patterns, especially in women over 50.
How It Presents
Women with mixed incontinence often describe a combination of:
- Leaking during physical activity, exercise, or when laughing or sneezing
- Sudden, strong urges to urinate that are difficult to control
- Sometimes leaking before reaching the bathroom
- Frequent trips to the bathroom during the day and night
One component is usually more bothersome than the other — this is called the “predominant” type and often guides initial treatment.
Mixed incontinence is actually the most common pattern I see in my practice. The good news is that we don’t have to fix everything at once. We start with the component that’s bothering you most, and often, improving one makes the other better too.
Treatment Approach
The key to treating mixed incontinence is a staged approach:
First, identify the predominant component — which type of leaking bothers you more? This guides where we start.
For the stress component:
- Pelvic floor physical therapy
- Weight management
- Pessary device
- Midurethral sling (if conservative measures aren’t sufficient)
For the urge component:
- Bladder training and behavioral strategies
- Dietary modifications (reducing caffeine, alcohol, irritants)
- Medications
- Botox injections or sacral neuromodulation
The overlap: Pelvic floor therapy helps both components. Strengthening the pelvic floor improves support for the urethra (stress) and can help suppress urgency signals (urge).
Why This Matters
Understanding that you have mixed incontinence — rather than just one type — helps set realistic expectations. Treating the stress component alone may not fully resolve your symptoms if urgency is also contributing, and vice versa. A comprehensive evaluation ensures both components are addressed.
I’m always transparent with patients about mixed incontinence. If we do a sling for the stress component, you’ll likely see a big improvement — but you may still have some urgency that needs separate treatment. Having that conversation upfront leads to better outcomes and greater satisfaction.
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