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经前列腺切除术治疗后出现尿失禁的患者采用或不采用度洛西汀进行盆底肌锻炼:一项回顾性单中心研究。

Pelvic floor muscle exercise with or without duloxetine for postprostatectomy urinary incontinence: A retrospective single-center study.

机构信息

Department of Urology, Gyeongsang National University Hospital, Gyeongsang National University, College of Medicine, Institute of Health Science, Jinju, Korea.

Department of Urology, Gyeongsang National University Changwon Hospital, Gyeongsang National University, College of Medicine, Institute of Health Sciences, Jinju, Korea.

出版信息

Medicine (Baltimore). 2023 Aug 11;102(32):e34657. doi: 10.1097/MD.0000000000034657.

Abstract

This study aimed to evaluate the effectiveness of combined pelvic floor muscle exercise (PFME) and duloxetine treatment in the recovery from postprostatectomy urinary incontinence (PPUI). Participants were patients who underwent radical prostatectomy (RP) between 2018 and 2021 and who were able to attend follow-up appointments every 3 months for at least 12 months. Continence was defined as the use of ≤1 pad per day. PPUI was compared at each follow-up period by dividing the participants into the PFME group (PFME only after RP) and the PFME + DUL group (PFME and 30 mg duloxetine daily after RP). A total of 197 patients were included. No significant differences were observed in the baseline characteristics between the 2 groups. In the PFME group (n = 127), the PPUI was 77.17%, 27.56%, 17.32%, 12.60%, and 9.45% at 2 weeks, 3 months, 6 months, 9 months, and 12 months, respectively. In the PFME + DUL group (n = 70), the PPUI was 62.50%, 17.86%, 12.50%, 8.93%, and 5.36%, respectively, at the same follow-up period. At 2 weeks, the PFME + DUL group demonstrated a better incontinence rate than the PFME group (P = .019). However, no significant differences were found in the incontinence rates between the 2 groups at each follow-up period after 3 months. Compared to PFME monotherapy, the combination therapy of PFME and duloxetine has short-term effectiveness in improving PPUI, but it does not have a significant long-term impact. Therefore, for early recovery from PPUI, duloxetine should be administered for a short period during PFME.

摘要

本研究旨在评估联合盆底肌锻炼(PFME)和度洛西汀治疗对前列腺切除术后尿失禁(PPUI)恢复的效果。参与者为 2018 年至 2021 年间接受根治性前列腺切除术(RP)且能每 3 个月至少随访 12 个月的患者。控尿定义为每天使用≤1 片尿垫。在每个随访期间,将参与者分为 PFME 组(仅在 RP 后进行 PFME)和 PFME+DUL 组(在 RP 后进行 PFME 和 30mg 度洛西汀每日治疗),比较两组的 PPUI。共纳入 197 例患者。两组基线特征无显著差异。在 PFME 组(n=127)中,2 周、3 个月、6 个月、9 个月和 12 个月时的 PPUI 分别为 77.17%、27.56%、17.32%、12.60%和 9.45%。在 PFME+DUL 组(n=70)中,相应时间点的 PPUI 分别为 62.50%、17.86%、12.50%、8.93%和 5.36%。2 周时,PFME+DUL 组的失禁率优于 PFME 组(P=.019)。但 3 个月后,两组在每个随访期间的失禁率均无显著差异。与 PFME 单一疗法相比,PFME 联合度洛西汀治疗在改善 PPUI 方面具有短期疗效,但对长期疗效无显著影响。因此,对于早期恢复 PPUI,在 PFME 期间应短时间给予度洛西汀。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f425/10419438/24be2eefcd6c/medi-102-e34657-g001.jpg

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