Pelvic floor muscle training improves stress urinary incontinence in women treated with duloxetine

This study investigated the effectiveness of pelvic muscle training (PMT) and duloxetine (Cymbalta) in women with stress urinary incontinence. Researchers suggested that PMT added to duloxetine treatment improves incontinence in women.

Stress urinary incontinence (SUI) is the most common form of incontinence, being present in 4 to 35% of adult women. It consists of the leakage of urine during physical activity, sneezing, or coughing (stress).

PMT is the first choice or treatment for stress incontinence. It improves pelvic muscle strength and relaxation and consists of repeated muscle contraction/relaxation training.

Duloxetine is an antidepressant that is also used for the treatment of SUI. It improves the urethral (urinary tube) function in retaining urine. Prior studies suggested that adding PMT to duloxetine improves further the treatment response. However, the effectiveness of PMT plus duloxetine to treat SUI in women is still not clear.

This study included information about 158 women with SUI. These patients were assigned to receive duloxetine alone (79, group 1) or PMT plus duloxetine (79; group 2).

Significant differences were observed between both groups after 12 weeks of treatment. Group 2 had a 66.7% decrease in incontinence frequency, while group 1 had a 50% decrease. Group 2 also had a 50% reduction in the number of pads per day used compared to 22.5% in group 1. 

Patients' impression of improvements increased by 70.8% in group 2 and 65.6% in group 1. The quality of life scores were increased by 19.3% in group 2 and 6.6% in group 1.  

This study concluded that PMT plus duloxetine improves the outcomes of women with SUI.

The education of women for the correct performance of the PMT exercises was limited since PMT was done at home with diary monitoring. Therefore, the results might have been affected.