Effect of routine duloxetine administration in the early postoperative period on postprostatectomy stress incontinence in patients undergoing laparoscopic radical prostatectomy

Abstract

Post-prostatectomy stress incontinence (PPI) is an important health problem for patients with radical prostatectomy history. Duloxetine is a common drug, used in PPI with the out of indications in most countries. In this study, we aimed to evaluate the prophylactic effect of duloxetine administration in PPI during the early postoperative period in patients undergoing laparoscopic radical prostatectomy (LRP). The retrospective study included 209 patients who underwent LRP. Patients were divided into two groups: Group I (n=96) was initiated on pelvic floor exercises (PFE) + duloxetine in the early postoperative period and continued this regimen for a total of 12 weeks and Group II (n=113) only performed PFE for 12 weeks after surgery. Exclusion criteria were as follows: a history of neuromuscular dysfunction of bladder, post-prostatectomy urge incontinence, receiving adjuvant radiotherapy during the 12- week period, prior anti-incontinence surgery, and post-voiding urine>100 ml. The prevalence rates of urinary incontinence measured at the time of urinary catheter removal (baseline) and at weeks 3, 6, and 12 after surgery and the number of wet pads per day were compared. The study included 209 patients with a mean age of 60.68 ± 7.16 years. Baseline urinary continence rates were similar in Group I and Group II (29.2% vs. 35.4%, p=0.338). At 12 weeks, although PPI rates have decreased in both groups, there was no difference between Group I and Group II (15.6% vs. 24.8%, p=0.103). Administration of prophylactic duloxetine in the early postoperative period, which started without regard to the positivity of PPI, is not significantly effective to early postoperative urinary continence recovery.