Mixed incontinence has characteristics of both urge and stress incontinence. This type of incontinence is common in women.
Overflow incontinence refers to the almost continual leakage of small amounts of urine associated with overdistention of the bladder. Leakage results when the pressure exerted by the urine accumulated in the bladder overcomes urethral pressure. Overdistention of the bladder can occur secondary to either outlet obstruction or to an underactive and acontractile detrusor (e.g., diabetic neuropathy, vitamin B12 deficiency). Outlet obstruction is rare in women but may be associated with severe pelvic prolapse or urethral stricture. Other common symptoms include hesitancy, interrupted or diminished urinary stream, straining to void, and a sense of incomplete emptying.
Finally, involuntary voiding of urine may occur despite normal bladder and urethral function. Functional incontinence can occur due to impairments in cognitive or physical functioning. Some functional incontinence is reversible if environmental barriers to toileting are eliminated. For example, a patient with a handicap such as severe arthritis or blindness may benefit from easy access to a bedside commode chair to regain control over bladder leakage. However, patients unable to recognize bladder cues (e.g., dementia) may need help from caregivers to manage their condition and avoid inappropriate voiding.