The SLIM Study: Sling and Botox Injection for Mixed Urinary Incontinence

Primary Aim: To determine whether synthetic retropubic midurethral sling (MUS) combined with concomitants detrusor injections of onabotulinumtoxinA is more effective than sling alone in improving mixed urinary incontinence (MUI) symptoms. Secondary Aims: a. To compare incontinence episode frequency on a 3-day diary in women who undergo midurethral sling plus onabotulinumtoxinA to those who undergo midurethral sling alone. b.To compare urinary incontinence symptoms and quality of life in women who undergo midurethral sling plus onabotulinumtoxinA to those who undergo midurethral alonge. c. To identify baseline factors associated with persistent urgency incontinence in women after midurethral sling alone and midurethral sling plus onabotulinumtoxinA.