Antimuscarinic therapy for the treatment of mixed incontinence.

Mixed urinary incontinence, the combination of stress incontinence and urge incontinence, affects millions of Americans, significantly impacting their quality of life. Treatment of mixed incontinence is a therapeutic challenge, and the debate over whether patients are best managed initially with medication or surgery is ongoing. The literature supports the efficacy of both antimuscarinic therapy and surgery for the treatment of mixed incontinence, but patient selection likely influences treatment outcome. Following is a literature review that critically evaluates the efficacy of antimuscarinic agents for the treatment of mixed incontinence and addresses some of the controversial issues regarding surgical and pharmacologic therapy. Clinical parameters that might influence therapeutic outcomes and recommendations regarding treatment are also presented.