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Duloxetine for male incontinence

Gedster
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  • 44 subscribers
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Hi, wonder if you have any information on duloxetine?

I have been on amitriptyline and pregabalin following a painful recovery after prostatectomy in January this year but I am severely incontinent (urinary).

I have just been prescribed duloxetine which apparently can help treat severe urinary incontinence. However this drug has a number of other uses (eg for fibromyalgia) and in periodicals seems to have been studied for incontinence in women. 

Is there any supporting evidence that this drug works for male incontinence after prostatectomy? I have searched the prostate forum but it doesn't appear to show its usage.

Also, as one of the very common side effects is constipation, and this has previously caused my pain to recur, I'm wondering about the overall benefit and whether I should simply give it a miss.

Many thanks in advance

Ged

  • Hi Ged,

    Thanks for getting in touch with us at Macmillan and a warm welcome to our online community. My name is Suzanne, and I am one of the cancer information nurse specialists.

    I am sorry to hear that you are experiencing long term effects from your prostatectomy. It is good to hear that you have already accessed some support from your GP or cancer specialist.  

    Urinary problems are unfortunately very common following surgery as the nerves and muscles controlling urinary flow can be damaged during this. This is why it’s so important to seek help to minimise and manage any issues.

    As you may know, there are a few approaches to managing and reducing this symptom, including medication, as detailed in the National Institute of Clinical Evidence (NICE) Guideline. This states that clinicians should:

    ‘Ensure that people with prostate cancer who have troublesome urinary symptoms after treatment have access to specialist continence services for assessment, diagnosis and conservative treatment. This could include coping strategies, pelvic floor muscle re-education, bladder retraining and pharmacotherapy’.

    Duloxetine is one of several possible medications that can be used to treat incontinence but, as you mention, it has a few potential side effects. This systematic review discusses the Use of Duloxetine for Postprostatectomy Stress Urinary Incontinence. Whilst evidence was found of its effectiveness, adverse side effects were relatively common. This 2023 study had similar findings.

    As with any treatment decision it is important to weigh up the risks and the benefits of each option. It would be worth discussing your concerns with your urology nurse specialist so that alternatives can be explored with you. That way you can make the best choice for you. You can also ask to be referred to a specialist incontinence service if you feel this would help you to choose the right treatment.

    I see that you are a member of our prostate cancer forum. This too may help you to seek insight from others who have had similar issues after surgery. Prostate Cancer UK also have a similar forum.

    I do hope this information helps Ged. If it would help to talk through your concerns, please don’t hesitate to call us on the support line. You can also use our online chat service if you prefer.

    I also wondered whether you would benefit from ordering our toilet card to help when you are out and about as this can be a major challenge. Bladder and Bowel UK have a similar card.

    Take care and best wishes.

     

    Suzanne, Cancer Information Nurse Specialist

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

    Ref/SF/JF

     

     

      

     

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