1. Challenges to Continence Promotion in the Middle East Chair: Diaa E.E. Rizk MSc, FRCOG, FRCS, MD Professor of Obstetrics and Gynaecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. * No conflict of interest declared

2. Aims of Workshop To describe the prevalence and socio-demographics of urinary and fecal incontinence in Middle Eastern women. To discuss cultural barriers as well as the challenges encountered with discussing this condition. To present continence awareness approaches in the Middle East. To review the success of the Rotterdam Public Forum and announce the launch of the World Continence Week.

3. Faculty Ahmed Al-Badr MBBS, FRCSC, FACOG Chairman, Urogynecology and Pelvic Reconstructive Surgery Women's Specialized Hospital, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. Vasan S Srini DNB, FICS Director, Manipal Andrology & Reproductive Services & Ankur, Head, Dept of Neurourology & Urodynamics, NU Hospitals, Bengaluru, India. Diane K Newman MSN, ANP-BC, CRNP, FAAN, BCIA-PMDB Co-Director, Penn Centre for Continence and Pelvic Health, Director, Clinical Trials, Division of Urology, University of Pennsylvania Medical Centre, Philadelphia, Pennsylvania, USA.

4. Presentations 1- Urinary incontinence in Middle Eastern women: A tale of three factors; Culture, Religion and Socialization of health role stereotypes Diaa E.E. Rizk 2- Epidemiology and consequences of female urinary incontinence in the Middle East Amed Al-Badr 3- Epidemiology and consequences of female fecal incontinence in the Middle East Diaa E.E. Rizk 4- Barriers to continence promotion in the Middle East S.S. Vasan 5- The importance of Public Forums in raising continence awareness in the Middle East Diane Newman

5. Key Learning Points 1- Urinary and fecal incontinence are common in Middle Eastern women who rarely seek medical help because of social traditions, cultural beliefs and lack of information. 2- Taboos on mentioning disorders of the bladder and rectum in women continue to be a challenge in Middle Eastern countries. 3- Middle Eastern countries should raise continence awareness and Public Forums such as ICS Rotterdam Forum (and ICS Cairo Forum) are important in achieving this objective.

6. Concluding Message Continence promotion in the Middle East must involve informing and educating the public and health care professionals that incontinence is not inevitable or shameful, but is treatable or at least manageable.