Duloxetine for the treatment of post-prostatectomy stress urinary incontinence

Abstract

E260 research researchCite as: Can Urol Assoc J 2013;7(5-6):e260-2. http://dx.doi.org/10.5489/cuaj.318 Published online May 13, 2013. AbstractObjectives: Stress urinary incontinence (SUI) is a known complication following prostatectomy. Duloxetine, a combined serotonin/ norepinephrine reuptake inhibitor, can decrease SUI by increasing urethral sphincter contractility. We examined the outcomes of patients with mild to moderate post-prostatectomy SUI treated with duloxetine. Methods: We conducted a retrospective review of men treated with duloxetine to manage mild to moderate post-prostatectomy SUI from 2006 to 2012. All patients received oral duloxetine 30 mg once a week, then 60 mg thereafter. Patients were seen one month later to determine drug efficacy and side effects. Results: In total, 94 men were included in the study. Daily pad usage decreased from 2.9 (range: 1-5) to 1.6 (range: 0-4) (p < 0.05). Incontinence Impact Questionnaire (IIQ-7) scores decreased from 13.0 (range: 6-18) to 7.9 (range: 2-16) (p < 0.05). Linear satisfaction scores improved from 0.8 (range: 0-2) to 2.0 (range: 1-3) (p < 0.05). Following a 1-month duloxetine trial, 33/94 (35%) men reported satisfactory SUI improvement and requested to continue the medication. The drug was discontinued in 61/94 (65%) patients due to poor efficacy in 32/94 (34%), intolerable side effects in 14/94 (15%) or both in 15/94 (16%). Reported side effects included fatigue, light-headedness, insomnia, nausea and dry mouth. Conclusions: Duloxetine improved post-prostatectomy SUI in 47/94 (50%) men following a 1-month trial. However, only 33/94 (35%) patients were able to tolerate the drug. Duloxetine may be considered a treatment option for men with mild to moderate post-prostatectomy SUI.

Priapism and renal colic in a patient treated with duloxetine

“… 20 Further, duloxetine has been approved in Europe as a treatment for stress urinary incontinence in females for over a decade. 21 …”

Radikal Prostatektomi Sonrasi Gorulen Stres Uriner Inkontinansta Duloksetinin Etkinligi

“…2013 yılında yapılan diğer bir çalışmada hafif-orta derecede idrar kaçırması (≤5 ped/gün) olan 94 postprostatektomi inkontinans hastası çalışmaya dahil edilmiş ve 1 ay süreyle 60 mg duloksetin tedavisi sonrası yaşam kalitesi skorlarında, tatmin skorlarında ve günlük ped kullanımında anlamlı derecede iyileşme olduğu görülmüştür. Hastaların %54'ünde günlük ped kullanımının yarı yarıya azaldığı gözlemlenmiştir (31). Ülkemizden yapılan bir çalışmada ise laparoskopik radikal prostatektomi sonrası inkontinası olan 60 hasta duloksetin ve PTE+duloksetin olmak üzere 2 gruba randomize edilmiştir.…”

Integrative review on the non‐invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies

“…Three studies examined SUI in patients treated with duloxetine, and both demonstrated that duloxetine improved postprostatectomy SUI up to 3 months postsurgery, but the benefits were not sustained in one of these studies up to 24 weeks (~5 months) 78, 91, 93. In addition, the drug intolerance and dropout rates are ~15–35% with duloxetine after ≥ 1 month of use 78, 93.…”

“…In addition, the drug intolerance and dropout rates are ~15–35% with duloxetine after ≥ 1 month of use 78, 93.…”