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**Part 3** 

**Surgical Options** 


**Part 3** 

**Surgical Options** 

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**12** 

*Korea University Republic of Korea* 

**Preoperative Factors as Predictors** 

**with Mixed Urinary Incontinence** 

Jin Wook Kim, Mi Mi Oh and Jeong Gu Lee

**of Outcome of Midurethral Sling in Women** 

Mixed urinary incontinence (MUI) presents with characteristics of both stress urinary incontinence (SUI) and urge urinary incontinence (UUI). It has been generally assumed to respond less favourably to any type of interventional therapy, whether behavioural, pharmacologic, or surgical as compared with pure stress (effort) or urge urinary incontinence. These patients represent a therapeutic challenge: two pathologies coexist, and treatment of either condition may worsen the symptoms of the other. The result is likely to be a poor response to conservative or surgical interventions. (Chaliha & Khullar, 2004)

The development of midurethral sling (MUS) surgery has become the gold standard for surgical treatment of SUI. There is great variability in data regarding cure rate of MUI following mid urethral sling (MUS) surgery of both the stress and urge components. Moreover, the postoperative course of the urge component after surgery is unpredictable as it may resolve, persist or worsen. There are no consistent predictors for persistent worsening of urge components after sling surgery. While there have been various factors described in the literature to predict who will be more likely benefit, these have not been clearly defined. Further compounding the difficulty is the lack of appropriate tools in delineating the characteristics of a mixed presentation. The poor response to treatment in MUI patients have led investigators to attempt quantifying and comparing dominance of either spectrum to

Despite such limitations, advance of treatment has allowed more aggressive combined approach to MUI, necessitating the delineation of patient profiles appropriate for each treatment method. Here we will review the current investigations analysing the two distinct pathophysiologies of MUI, as well as the suggested factors determining the outcome

MUI is the coexistence of stress and urgency urinary incontinence and is defined as involuntary loss of urine associated with the sensation of urgency and also associated with exertion, effort, sneezing or coughing.(Haylen et al., 2010) Mixed incontinence can also be

dictate a priority of treatment and quantitatively assess outcome.

**1. Introduction** 

following MUS treatment.

**2. Prevalence of MUI** 
