Pharmacologic treatment in postprostatectomy stress urinary incontinence.
OBJECTIVE
The aim of this study was to assess efficacy and safety of association of duloxetine and rehabilitation compared with rehabilitation alone in men with SUI after radical retropubic prostatectomy (RRP), and to compare continence rate even after planned duloxetine suspension.


METHODS
After catheter removal, 112 patients were randomized to receive rehabilitation and duloxetine (group A) or rehabilitation alone (group B), for 16 wk.


METHODS
postprostatectomy SUI with daily incontinent episodes frequency (IEF) of four or greater. After 16 wk both groups suspended duloxetine/placebo and continued rehabilitation. All patients completed incontinence quality of life (I-QoL) questionnaire and bladder diary. Wilcoxon test was used to analyse changes in IEF and in I-QoL score; Fisher exact test was used to compare continent patients between the groups.


RESULTS
Adverse events for duloxetine was 15.2%. 102 men completed the study. There was a significant decrease in pad use in group A. After 16 wk, 39 patients versus 27 were dry (p=0.007). At 20 wk, 4 wk after planned interruption of duloxetine, we observed a U-turn, 23 patients were completely dry in group A versus 38 in group B (p=0.008). Whereas, after 24 wk, 31 in group A versus 41 in group B were dry (p=0.08). The decrease in IEF and improvements in I-QoL scores were significantly greater in group A for the first 16 wk.


CONCLUSIONS
The data suggest that combination therapy might provide another treatment option for SUI in men that might increase the percentage of early postsurgery continence.
Filocamo
Maria Teresa
MT
Clinica Urologica II, University of Florence, Florence, Italy. mt.fil@libero.it
Li Marzi
Vincenzo
V
Del Popolo
Giulio
G
Cecconi
Filippo
F
Villari
Donata
D
Marzocco
Michele
M
Nicita
Giulio
G
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D000068736:Duloxetine Hydrochloride; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000534:rehabilitation; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D018709:Statistics, Nonparametric; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000188:drug therapy* / Q000534:rehabilitation
D018759:Adrenergic Uptake Inhibitors; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride