REVIEW Impact of Overactive Bladder-Wet Syndrome on Female Sexual Function: A Systematic Review and Meta-Analysis Matteo Balzarro, MD, 1 Emanuele Rubilotta, MD, 1 Vito Mancini, MD, 2 Nicolò Trabacchin, MD, 1 Leila Oppezzi, MD, 3,4 Vincenzo Li Marzi, MD, 5 Ferdinando Fusco, MD, 6 and Maurizio Serati, MD 7 ABSTRACT 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 0.26e0.45). 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. Balzarro M, Rubilotta E, Mancini V, et al. Impact of Overactive Bladder-Wet Syndrome on Female Sexual Function: A Systematic Review and Meta-Analysis. Sex Med Rev 2019;XX:XXXeXXX. Copyright Ó 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. Key Words: Overactive Bladder; OAB Wet; Female Sexuality; Female Sexual Dysfunction; OAB Treatment INTRODUCTION Overactive bladder (OAB) syndrome is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urinary incontinence, and in the absence of urinary tract infection or any other obvious disease. 1,2 OAB is subtyped into OAB-wet and OAB-dry, based on the presence or absence, respectively, of urgency urinary incontinence (UUI). Although studies on UUI also have methodologic variance, UUI clearly Received January 21, 2019. Accepted May 18, 2019. 1 Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy; 2 Department of Urology and Renal Transplantation, Università di Foggia, Foggia, Italy; 3 Department of Anaesthesia, Clinical Care and Pain Therapy, University of Verona, Verona, Italy; 4 Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy; 5 Department of Urologic Robotic Surgery and Renal Transplantation, Ospedale di Careggi, Università di Firenze, Florence, Italy; 6 Department of Neuroscienze, scienze della riproduzione ed odontostoma- tologia, Università Federico II, Napoli, Italy; 7 Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy Copyright ª 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.sxmr.2019.05.002 Sex Med Rev 2019;-:1e10 1