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Sand PK, Goldberg RP, Dmochowski RR, McIlwain M, Dahl NV. The impact of the overactive bladder syndrome on sexual function: a preliminary report from the Multicenter Assessment of Transdermal Therapy in Overactive Bladder with Oxybutynin trial. Am J Obstet Gynecol 2006;195:1730-1735.

This work is a result of the preliminary “Multicenter Assessment of Transdermal Therapy in Overactive Bladder (OAB) with Oxybutynin study”. The relationship between pelvic health (eg, incontinence, pelvic organ prolapse) and sexual dysfunction has been evaluated in previous studies; however, few studies have evaluated the impact of OAB syndrome on patient interest in sexual activity. OAB is a syndrome consisting of a combination of symptoms including urinary urgency with or without urge urinary incontinence, urinary frequency, and nocturia. Bladder control problems can result from a variety of physical, functional, and psychological changes. Many individuals use coping mechanisms to manage OAB symptoms. Patients with bladder control problems tend to isolate themselves from social interaction and are predisposed to depression and sexual dysfunction

Methods
The Multicenter Assessment of Transdermal Therapy in Overactive Bladder with Oxybutynin study was an open-label, prospective trial of 2878 subjects with overactive bladder, treated with transdermal oxybutynin for 6 months or less. The impact of overactive bladder on sexual function before and after treatment was assessed via item responses from the King's Health Questionnaire and Beck Depression Inventory-II (kappa-test).

Results
At baseline, 23.1% reported that overactive bladder had an impact on their sex life. Coital incontinence in 22.8% decreased after treatment to 19.3%. Effects of overactive bladder on subjects' sex lives improved in 19.1% (worsened in 11.2%), and the effect on relationships with partners improved in 19.6% (worsened in 11.9%). Reduced interest in sex, reported by 52.1% at baseline, improved significantly. (all P < .0001).

Conclusions

• OAB had a profound effect on sexual function and marital or conjugal relationships.
• Overactive bladder negatively affects sexual function.
• Treatment with transdermal oxybutynin improved sexual function and marital relationships.
• Clinicians should address OAB-related anxiety about sexual activity and the impact of this concern on sexual intimacy and marital relationships when caring for patients with OAB.