Neff Donald, Guise Amy, Guralnick Michael L, Langenstroer Peter, See William A, Jacobsohn Kenneth M, O'Connor R Corey
Department of Urology, Medical College of Wisconsin, Milwaukee, WI.
Can Urol Assoc J. 2013 May-Jun;7(5-6):E260-2. doi: 10.5489/cuaj.318.
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.
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.
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.
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.
压力性尿失禁（SUI）是前列腺切除术后已知的并发症。度洛西汀是一种5-羟色胺/去甲肾上腺素再摄取抑制剂，可通过增强尿道括约肌收缩力来减少SUI。我们研究了接受度洛西汀治疗的轻至中度前列腺切除术后SUI患者的治疗结果。
我们对2006年至2012年期间接受度洛西汀治疗轻至中度前列腺切除术后SUI的男性患者进行了一项回顾性研究。所有患者每周口服一次30mg度洛西汀，之后为60mg。1个月后对患者进行检查以确定药物疗效和副作用。
该研究共纳入94名男性。每日尿垫使用量从2.9片（范围：1 - 5片）降至1.6片（范围：0 - 4片）（p < 0.05）。尿失禁影响问卷（IIQ - 7）评分从13.0分（范围：6 - 18分）降至7.9分（范围：2 - 16分）（p < 0.05）。线性满意度评分从0.8分（范围：0 - 2分）提高到2.0分（范围：1 - 3分）（p < 0.05）。在进行1个月的度洛西汀试验后，33/94（35%）的男性报告SUI有满意改善并要求继续用药。61/94（65%）的患者因疗效不佳（32/94，34%）、无法耐受的副作用（14/94，15%）或两者皆有（15/94，16%）而停药。报告的副作用包括疲劳、头晕、失眠、恶心和口干。
经过1个月的试验，度洛西汀使47/94（50%）的前列腺切除术后SUI男性患者病情得到改善。然而，只有33/94（35%）的患者能够耐受该药物。度洛西汀可被视为轻至中度前列腺切除术后SUI男性患者的一种治疗选择。
