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Abstract: Context: Overactive bladder (OAB) is a prevalent condition that has a significant negative impact on almost all aspects of health-related quality of life (HRQoL). Urgency is the core symptom experienced by all patients who have OAB, either with or without urgency urinary incontinence (UUI). Objective: To describe the assessment and impact of UUI on patients’ HRQoL. Evidence acquisition: A nonsystematic review of the literature including PubMed and congress abstracts was performed in 2010. Evidence synthesis: Urodynamic measures are not necessarily predictive of the impact of OAB symptoms on the individual patient. Thus the use of validated, disease-specific instruments to assess patient-reported outcomes such as symptom bother, HRQoL, treatment satisfaction, and symptom frequency and severity has become standard in the diagnosis and treatment of OAB. Use of these measures in clinical research has shown that OAB with UUI has a greater impact on HRQoL than OAB without UUI, and reduction of UUI episodes is an important goal for patients with OAB with UUI. The impact of UUI on HRQoL is also greater than that of stress urinary incontinence or other types of urinary incontinence. Furthermore, UUI episodes contribute substantially to the personal and societal cost burden of OAB. Conclusions: Effective treatment of OAB symptoms, focussing on UUI, is essential to improve patient HRQoL and to minimise the costs associated with this condition. [Copyright &y& Elsevier]

Abstract Introduction Coital urinary incontinence (CUI) is not much explored during clinical history, and this could lead to an underestimation of the problem. Aim To evaluate the prevalence and clinical risk factors of CUI in women with urinary incontinence (UI), and to measure the impact of CUI on women's sexuality and quality of life. Methods This was a multicenter international study, conducted in Italy, Greece, the United States, and Egypt. Inclusion criteria were: sexually active women with UI and in a stable relationship for at least 6 months. Exclusion criteria were: age <18 years and unstable relationship. The UI was classified as stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Women completed a questionnaire on demographics and medical history, in particular on UI and possible CUI and the timing of its occurrence, and the impact of CUI on quality and frequency of their sexual life. Main Outcome Measures To evaluate the CUI and its impact on sexual life we used the open questions on CUI as well as the International Consultation on Incontinence questionnaire and Patient Perception of Bladder Condition questionnaire. Results In this study 1,041 women (age 52.4 ± 10.7 years) were included. In all, 53.8% of women had CUI: 8% at penetration, 35% during intercourse, 9% at orgasm, and 48% during a combination of these. Women with CUI at penetration had a higher prevalence of SUI, women with CUI during intercourse had higher prevalence of MUI with predominant SUI, and women with CUI at orgasm had higher prevalence of UUI and MUI with predominant UUI component. Previous hysterectomy was a risk factor for CUI during any phase, while cesarean delivery was a protective factor. Previous failed anti-UI surgery was a risk factor for CUI during penetration and intercourse, and body mass index >25 kg/m2 was a risk factor for CUI at intercourse. According to International Consultation on Incontinence questionnaire scores, increased severity of UI positively correlated with CUI, and had a negative impact on the quality and frequency of sexual activity. Clinical Implications This study should encourage physicians to evaluate the CUI; in fact, it is an underestimated clinical problem, but with a negative impact on quality of life. Strengths & Limitations The strength of this study is the large number of women enrolled, while the limitation is its observational design. Conclusion CUI is a symptom that can affect sexual life and should be investigated during counseling in all patients who are referred to urogynecological centers. Illiano E, Mahfouz W, Giannitsas K, et al. Coital Incontinence in Women With Urinary Incontinence: An International Study. J Sex Med 2018;15:1456–1462. [ABSTRACT FROM AUTHOR]