Department of Urology, University of Mersin School of Medicine, Mersin, Turkey.
Department of Urology, Ankara City Hospital, Ankara, Turkey.
Arch Gynecol Obstet. 2023 Sep;308(3):1037-1042. doi: 10.1007/s00404-023-07123-4. Epub 2023 Jun 29.
Stress urinary incontinence (SUI) is defined as urinary incontinence that occurs with coughing, sneezing, and physical exercise. It is frequently observed in women after middle age and has a negative impact on their sexual function. Duloxetine as one of the Serotonin-noradrenaline reuptake inhibitors (SNRIs) is commonly used in the non-surgical treatment of SUI. The aim of our study is to investigate the effect of duloxetine, which is used in the treatment of SUI, on sexual functions in female patients.
The study included 40 sexually active patients who received duloxetine 40 mg twice a day for the treatment of SUI. All patients had female sexual function index (FSFI), Beck's depression inventory (BDI), and incontinence quality of life score (I-QOL) applied before and 2 months after starting duloxetine treatment.
FSFI total score significantly increased from 19.9 to 25.7 (p < 0.001). In addition, significant improvement was observed in all sub-parameters of FSFI, including arousal, lubrication, orgasm, satisfaction, and pain/discomfort (p < 0.001, for each FSFI subtotal score). BDI significantly decreased from 4.5 to 1.5 (p < 0.001). I-QOL score significantly increased from 57.6 to 92.7 after the duloxetine treatment.
Although SNRIs carry a high risk of sexual dysfunction, duloxetine may have an indirect positive effect on female sexual activity, both through its stress incontinence treatment and its antidepressant effect. In our study, Duloxetine, one of the treatment options for stress urinary incontinence and an SNRI, has a positive effect on stress urinary incontinence, mental health, and sexual activity in patients with SUI.
压力性尿失禁(SUI)定义为咳嗽、打喷嚏和体育锻炼时发生的尿失禁。它在中年后妇女中经常观察到,并对其性功能有负面影响。度洛西汀作为去甲肾上腺素和 5-羟色胺再摄取抑制剂(SNRIs)之一,常用于治疗 SUI 的非手术治疗。我们的研究目的是探讨度洛西汀治疗 SUI 对女性患者性功能的影响。
该研究纳入了 40 名接受度洛西汀 40mg 每日两次治疗 SUI 的活跃患者。所有患者在开始度洛西汀治疗前和治疗 2 个月后均接受了女性性功能指数(FSFI)、贝克抑郁量表(BDI)和失禁生活质量评分(I-QOL)。
FSFI 总分从 19.9 显著增加到 25.7(p<0.001)。此外,FSFI 的所有子参数均显著改善,包括性欲、润滑、高潮、满意度和疼痛/不适(p<0.001,每个 FSFI 子总分)。BDI 从 4.5 显著下降到 1.5(p<0.001)。度洛西汀治疗后 I-QOL 评分从 57.6 显著增加到 92.7。
尽管 SNRIs 存在性功能障碍的高风险,但度洛西汀可能通过其治疗压力性尿失禁和抗抑郁作用对女性性活动产生间接积极影响。在我们的研究中,度洛西汀是治疗压力性尿失禁和 SNRI 的一种选择,对压力性尿失禁、心理健康和 SUI 患者的性活动有积极影响。