Duloxetine as a possible treatment for post-surgical incontinence

Duloxetine (Cymbalta®) is a drug that is approved in the USA for the treatment of depression, anxiety disorder, and certain specific types of pain. However, there are also data showing that it can be effective in the management of stress urinary incontinence (SUI) in women.

Cornu et al. have now published data from a pilot study designed to see if duloxetine could be used to manage mild to moderate symptoms of incontinence after radical prostatectomy for treatment of prostate cancer. 

Their study was a prospective, randomized, placebo-controlled, double-blind trial comparing treatment with duloxetine (80 mg/day) to treatment with a placebo for a period of 3 months. The primary outcome measure was variation in the frequency of episodes of urinary incontinence (IEF) at the end of study compared to baseline.

The core results of the study were as follows:

  • 31 patients were randomized to duloxetine (n = 16) or a placebo (n = 15).
  • Reduction in IEF at 3 months was significant.
    • Relative mean reduction in IEF for patients receiving duloxetine was –52.2 ± 38.6 percent (range, –100 to +46 percent).
    • Relative mean reduction in IEF for patients receiving a placebo was +19.0 ± 43.5 percent (range, –53 to +104 percent)
    • The mean difference was 71.2 percent.
    • Both treatments were well tolerated.

Data from validated questionnaires suggest that duloxetine treatment also improved quality of life in  patients with SUI after a radical prostatectomy.

The authors conclude that duloxetine is effective in the treatment of incontinence symptoms in men with SUI after a radical prostatectomy.

Clearly this is is just a small, hypothesis-generating study, but The “New” Prostate Cancer InfoLink hopes that this may lead to a larger, randomized clinical trial. The availability of a simple form of drug therapy to help manage symptoms of incontinence after surgery would offer considerable relief and benefit for many men.

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