A Randomized Controlled Trial of Duloxetine Alone, Pelvic Floor Muscle Training Alone, Combined Treatment and No Active Treatment in Women With Stress Urinary Incontinence

Ghoniem, Gamal M.; Leeuwen, Jules Schagen van; Elser, Denise M.; Freeman, Robert; Zhao, Yan; Yalcin, Ilker; Bump, Richard C.

doi:10.1097/01.ju.0000154167.90600.c6

Cited by 153 publications

(122 citation statements)

References 15 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…56 There is some evidence to suggest that this drug may be more useful as an adjunct to other conservative therapies, such as PFMT. 57 Despite poor tolerability and modest efficacy, the prescribing of this drug appears to be increasing in the UK (Figure 4). Further details on the current use of SNRI's were obtained from a survey of members of the Association of Continence Advisors (ACA).…”

Section: Serotonin-noradrenaline Reuptake Inhibitormentioning

confidence: 99%

“…57 157,162,190 assignment based on hospital casenote number 116 or assignment based on time of arrival at the clinic and severity of incontinence. 127 Allocation concealment was also considered to be suboptimal (sealed envelopes with no indication of third party involvement) in a further five studies.…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…57,117,128,[130][131][132][133][134][136][137][138][139][140][141][142][143][144][145]189 Twelve of these involved drug therapy and used a placebo to blind participants. 57,117,[136][137][138][139][140][141][142][143][144][145] In the other seven studies, participants were blinded through sham ES, [130][131][132][133][134]189 or imitation or placebo PFMT. 57,128 Six studies (6.8%) reported that health-care providers were blinded.…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

Imamura

Abrams²,

Bain³

et al. 2010

Health Technol Assess

165

View full text Add to dashboard Cite

How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projec...

show abstract

Section: Serotonin-noradrenaline Reuptake Inhibitormentioning

confidence: 99%

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

Imamura

Abrams²,

Bain³

et al. 2010

Health Technol Assess

165

View full text Add to dashboard Cite

show abstract

“…However, this study was planned as a proof of principle study and based on these findings, randomised placebo controlled clinical trials on patients with SUI and age matched healthy subjects are a necessary next step. Our intention was to show the possible mechanism behind a combined treatment of PFMT and duloxetine, which was demonstrated as beneficial in a randomized placebo controlled trial by Ghoniem et al [14].…”

Section: Discussionmentioning

confidence: 99%

“…Up to day there is only one randomized controlled clinical trial investigating the combined treatment of PFMT and duloxetine in women with SUI [14]. The results suggested an additive effect of a combined treatment.…”

Section: Introductionmentioning

confidence: 99%

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons

et al. 2009

View full text Add to dashboard Cite

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons Abstract INTRODUCTION AND HYPOTHESIS: Aim of this study was to investigate the excitability of sphincter motor neurons under the influence of pelvic floor muscle training (PFMT) and duloxetine. Due to their mechanisms of action, there might be a synergistic effect of duloxetine and PFMT in regard to the facilitation of spinal reflexes controlling urethral sphincter contractions and hence continence. METHODS: In ten healthy female subjects, clitoral electric stimulation (CES) and transcranial magnetic stimulation (TMS) were used to determine individual motor thresholds for external urethral sphincter (EUS) contractions before and after PFMT, duloxetine, and PFMT + duloxetine. RESULTS: PFMT and duloxetine alone significantly decreased the motor thresholds for EUS contractions during CES and TMS. However, the combined treatment reduced the motor threshold for EUS contractions significantly stronger compared to PFMT or duloxetine alone. CONCLUSIONS: The results are suggestive for a synergistic facilitatory effect of PFMT and duloxetine on sphincter motor neuron activation.The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons.

show abstract

Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults

Mariappan

Alhasso

Grant

et al. 2005

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

The available evidence suggests that duloxetine treatment can significantly improve the quality of life of patients with stress urinary incontinence, but it is unclear whether or not benefits are sustainable. Adverse effects are common but not serious. About one in three participants allocated duloxetine reported adverse effects (most commonly nausea) related to treatment, and about one in eight allocated duloxetine stopped treatment as a consequence.

show abstract

A Randomized Controlled Trial of Duloxetine Alone, Pelvic Floor Muscle Training Alone, Combined Treatment and No Active Treatment in Women With Stress Urinary Incontinence

Abstract: The data support significant efficacy of combined PFMT and duloxetine in the treatment of women with SUI. We hypothesize that complementary modes of action of duloxetine and PFMT may result in an additive effect of combined treatment.

Cited by 153 publications

References 15 publications

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons

Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults

Contact Info

Product

Resources

About