Mixed Incontinence: Medical Or Surgical Approach?

Inclusion Criteria:

1. Female

2. Mixed UI as evidenced by stress and urge symptoms reported on MESA (either percent of
urge-type symptoms ≥ the percent of stress-type symptoms or urge symptom score ≥7 if
stress predominant) followed by report of "moderately" or "greatly"/"quite a bit"
bothered to questions 2 and 3 of the 6-item Urinary Distress Index (UDI-6) or
questions 16 and 17 of the 20-item Pelvic Fl;oor Distress Index (PFDI-20),
respectively (See Appendix C)

3. Moderate or severe UI as evidenced by the corresponding response on the Patient
Global Impression of Severity (PGI-S)

4. Incontinence symptoms present for at least (3) months*

5. Bladder capacity > 200cc (by any method)

6. Urodynamic Stress Incontinence

7. Eligible for both treatment interventions

8. Available to start intervention within 6 weeks

9. Negative urine dipstick (negative result = trace or less for leukocytes & nitrites)

10. Available for 12 months of follow-up and able to complete study assessments as per
clinician judgment

11. Signed consent form

Exclusion Criteria:

1. Age <21 years*

2. Currently undergoing or recommended to undergo treatment of pelvic organ prolapse

3. Other indicated/planned concomitant surgery

4. Pregnant or has not completed child bearing*

5. <12 months post-partum*†

6. Active malignancy of cervix, uterus, fallopian tube(s) or ovary > Stage I, or bladder
of any Stage

7. Current catheter use

8. Unevaluated hematuria

9. Participation in another trial that may influence the results of this study

- Patient can be rescreened after respective time interval has been met. †"Partum"
is defined as a delivery or other termination that occurs after 20 weeks
gestation.