title: Use of symptom-relieving drugs before and after surgery for urinary incontinence in women: a cohort study.
abstract: OBJECTIVE
  To describe the use of symptom-relieving drugs (antimuscarinic drugs or duloxetine) before and after surgery for urinary incontinence (UI); and for those with use of antimuscarinic drugs or duloxetine before surgery, to estimate the risk of being a postoperative user, relative to those without use before surgery.
  
  
  METHODS
  A historical population-based cohort study.
  
  
  METHODS
  Denmark.
  
  
  METHODS
  Women ≥18 years with a first-time surgical procedure for UI from the county of Funen, Denmark between 1 January 1996 and 31 December 2006, extended to the Region of Southern Denmark from 1 January 2007 to the end of 2010. For these women, data on redeemed prescriptions ±365 days of date of surgery were extracted.
  
  
  METHODS
  Effect of preoperative use of antimuscarinic drugs or duloxetine on the risk of being a postoperative user of these drugs.
  
  
  RESULTS
  Of 2151 women with a first-time surgical procedure for UI, 358 (16.6%) were preoperative users of antimuscarinic drugs or duloxetine and 1793 were not (83.4%). A total of 110 (30.7%) of the preoperative users also redeemed prescriptions for these drugs within 0-60 days after surgery, and 152 (42.5%) of the preoperative users redeemed prescriptions for these drugs within 61-365 days after surgery. Among preoperative non-users, 25 (1.4%) and 145 (8.1%) redeemed prescriptions within 0-60 and 61-365 days after surgery, respectively. Presurgery exposure to antimuscarinic drugs or duloxetine was a strong risk factor of postoperative drug use, both within 0-60 days (adjusted OR=33.0, 95% CI 20.0 to 54.7) and 61-365 days (OR=7.2, 95% CI 5.4 to 9.6).
  
  
  CONCLUSIONS
  A substantial number of women will continue to be prescribed symptom-relieving drugs after surgery for UI within a year of follow-up. Only a minority of preoperative non-users initiated usage of symptom-relieving drugs after surgery. Compared with other factors included in the regression model, preoperative use of antimuscarinic drugs or duloxetine was the strongest risk factor for postoperative use.
authors.affiliation: Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Guldberg
authors.forename: Søren
authors.initials: S
authors.lastname: Brostrøm
authors.forename: Ulrik Schiøler
authors.initials: US
authors.lastname: Kesmodel
authors.forename: Linda
authors.initials: L
authors.lastname: Kærlev
authors.forename: Jesper Kjær
authors.initials: JK
authors.lastname: Hansen
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.forename: Bente Mertz
authors.initials: BM
authors.lastname: Nørgård
keywords: Antimuscarinic drugs; Clinical epidemiology; Duloxetine; SURGERY; Urinary incontinence