The CONTINUE study aims to delineate the patient profile suffering from double incontinence (urinary and faecal), its adverse impact on quality of life, and to identify risk factors associated with severe faecal incontinence. 
Given the prevalent nature of these conditions and their significant socioeconomic and personal health implications, including sexual dysfunction and quality of life degradation, this study endeavors to provide comprehensive insights into the multifactorial risks contributing to severe faecal incontinence among urinary incontinence patients.

Employing a multicenter, population-based cross-sectional design, the CONTINUE study prospectively collected baseline characteristics, comorbidities, and scores from urinary incontinence (ICIQ-SF), faecal incontinence (Wexner Scale), Quality of Life (SF-36), and Physical Disability (Barthel Index) questionnaires from male and female patients evaluated for urinary incontinence in Urology clinics. Both univariate and multivariate analyses were performed to identify risk factors for severe faecal incontinence in conjunction with urinary incontinence.

The study included 430 patients with urinary incontinence (ICIQ-SF ≥ 1), among whom 45.1% (194/430) presented with severe faecal incontinence (Wexner ≥ 9). The mean age was 62.6 years (±13.3), with a female predominance (79.5%, 342/430).
Patients were further classified into six groups based on the severity of urinary (IU) and faecal incontinence (IF). The prevalence of severe faecal incontinence (Wexner >9) was notably higher in patients with severe urinary incontinence (142/261). These categories are presented in Figure #1.
Across the groups, the level of independence as measured by the Barthel Index decreased in line with the severity of incontinence; patients with both severe faecal and urinary incontinence demonstrated the highest levels of dependency. 
The mean scores for physical function, role-physical, body pain, general health, vitality, social functioning, role-emotional, and mental health (as assessed by the SF-36) deteriorated progressively with the increasing severity of incontinence. Notably, the subgroup with severe double incontinence showed the lowest quality of life scores and highest levels of declared health deterioration.
There results are summarised in Figure #2.

The findings underscore the high prevalence and detrimental effect of severe faecal incontinence on the quality of life among individuals with urinary incontinence. The association between severe faecal incontinence and lower quality of life and physical functioning scores indicates a significant burden on affected individuals.
The stratification of incontinence severity revealed a direct correlation between the level of incontinence and quality of life deterioration. The group with severe double incontinence consistently reported lower quality of life and higher dependency in daily activities. This association underscores the compounded impact of dual incontinence on patients' well-being and highlights the need for specialized management strategies.

The study corroborates the hypothesis that dual incontinence severity is inversely correlated with quality of life and functionality. 
The pronounced impact observed in the severe double incontinence group advocates for an integrated clinical approach tailored to the multifaceted needs of these patients. 
These insights emphasize the imperative for early identification and comprehensive management of incontinence to mitigate its detrimental effects on patients' lives.