Duloxetine for the treatment of post-prostatectomy stress urinary incontinence

Authors

  • Donald Neff Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Amy Guise Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Michael L. Guralnick Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Peter Langenstroer Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • William A. See Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • Kenneth M. Jacobsohn Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
  • R. Corey O’Connor Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin

DOI:

https://doi.org/10.5489/cuaj.318

Keywords:

Post-prostatectomy, urinary incontinence, treatment

Abstract

Objectives: 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.

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Published

2013-05-13

How to Cite

Neff, D., Guise, A., Guralnick, M. L., Langenstroer, P., See, W. A., Jacobsohn, K. M., & O’Connor, R. C. (2013). Duloxetine for the treatment of post-prostatectomy stress urinary incontinence. Canadian Urological Association Journal, 7(5-6), e260–2. https://doi.org/10.5489/cuaj.318

Issue

Section

Original Research