Impact of Overactive Bladder-Wet Syndrome on Female Sexual Function: A Systematic Review and Meta-Analysis

Introduction: Overactive bladder (OAB) is subtyped into OAB-wet and OAB-dry, based on the presence or absence, respectively, of urgency incontinence. Although women with OAB frequently have a higher risk for sexual dysfunction, a systematic review on the impact of OAB-wet on female sexuality is lacking. This may be evaluated by measuring the effect of the bladder condition on sexuality per se, or by the effect of OAB treatment on female sexual dysfunction. Aim: To assess the role of OAB-wet on female sexual function. Methods: A systematic review of the literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement recommendations. Research on PubMed, EMBASE, and SCOPUS was performed and concluded on October 15, 2018. A systematic computerized search was conducted on published literature from January 1, 2000e2018. Meta-analysis was performed with a meta-analysis program. Main Outcomes Measures: The following search terms were used: ((( female sexual function) OR (female sexual dysfunction) OR (female sexuality) OR (dyspareunia)) AND ((overactive bladder) OR (coital incontinence) OR (detrusor instability) OR (detrusor overactivity) OR (urge urinary incontinence) OR (onabotulinumtoxinA) OR (botulinum) OR (sacral neuromodulation) OR (SNM) OR (PTNS) OR (stoller afferent neuro-stimulation) OR (SANS) OR (antimuscarinic drugs) OR (anticholinergic) OR (peripheral neuromodulation) OR (beta-agonist))). Results: 1,033 references were reviewed for inclusion and exclusion criteria. Final analysis identified 12 articles for systematic review. OAB-wet was reported as the most affecting factor on sexuality. OAB treatments showed improvement of both the OAB-wet and the sexual function. Results of the meta-analysis suggested that OAB therapies improving OAB-wet significantly reduced female sexual dysfunction (odds ratio 0.19; 95% CI 0.26-0.45). Conclusion: OAB-wet represents a risk for sexual dysfunction; however, data available show low-quality evidence of the impact of OAB-wet on sexual dysfunction. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.