Clinical
Male Stress Urinary Incontinence (Post Prostatectomy Incontinence)
Chang Seok Kang Department of Urology, Gyeongsang National University Hospital, Gyeongsang National University, College of medicine, Institute of Health Science, 79 Gangnam-ro, Jinju, Korea
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Abstract Centre
Duloxetine is a medication that is primarily used to treat depression and anxiety disorders, but it has also been studied for its potential to improve postprostatectomy urinary incontinence. In this study, the efficacy of combined treatment of pelvic floor muscle exercises (PFME) and duloxetine in the recovery of postprostatectomy urinary incontinence was investigated
This study is a retrospective data analysis study of a single medical institution. The subjects were patients who underwent RP for prostate cancer at this medical institution from June 2018 to June 2021 and could follow up every 3 months for at least 12 months. Continence was defined as one or less pad used per day. Incontinence patterns were compared by classifying them into the PFME group, in which only PFME was performed after RP, and the PFME+DUL group, in which PFME and duloxetine 30 mg were administered once a day after radical prostatectomy. The urinary incontinence rate at the follow-up period of each group was statistically analyzed using Pearson's Chi-square test.
A total of 183 patients were included in the study. The mean age of the PFME group was 71.42 years and that of the PFME+DUL group was 72.57 years (p=0.285). Also, the two groups had no statistical difference in mean PSA, nerve sparing, and catheter removal time. In the PFME group, the rate of urinary incontinence was 77.17% at 2 weeks, 27.56% at 3 months, 17.32% at 6 months, 12.60% at 9 months, and 9.45% at 12 months. In the PFME+DUL group, urinary incontinence was 62.50% at 2 weeks, 17.86% at 3 months, 12.50% at 6 months, 8.93% at 9 months, and 5.36% at 12 months. At 2 weeks, the PFME+DUL group was better than the PFME group in the rate of incontinence (p = 0.040). But, at 3 months, 6 months, 9 months, and 12 months, there was no statistical difference in incontinence rates between the two groups (p = 0.160, 0.410, 0.473, and 0.532, respectively at each follow-up period).
Combination therapy with PFME and duloxetine is thought to be more helpful for early recovery of urinary incontinence after prostatectomy than PFME alone. However, since the addition of duloxetine did not show a significant effect compared to PFME alone after 3 months, long-term administration of duloxetine does not seem to have a significant effect on the recovery of urinary incontinence.
The combination treatment of PFME and duloxetine is thought to be helpful for early recovery of urinary incontinence after prostatectomy. The limitation of this study is that the number of subjects was small and that it was a retrospective study.