Urodynamic evaluation of lower urinary tract (LUT) function is not a physiological test. However, it is still the best available tool for LUT function assessment. Even if normality in UDS can be defined, tests must always be interpreted against patient characteristics, complaints, and symptoms.

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.

This study aims to provide reference ranges of normal variability in urodynamic parameters through literature review of normal urodynamic values in the literature. Data were obtained through MEDLINE from articles published between January 1956 and February 2011, International Continence Society meeting abstracts and standardization reports. Search terms included urodynamics, bladder diary, uroflowmetry, frequency volume charts, pad tests, normal control, and normal volunteer. Normal values varied widely in the literature. However, with the help of clinical data, it was possible to define "normality" ranges for most of the different parameters. Urodynamic evaluation of lower urinary tract (LUT) function is not a physiological test. However, it is still the best available tool to assess LUT function. Even if normality in urodynamics can be defined, tests must always be interpreted against patient characteristics, complaints, and symptoms.