Impact of innovative pelvic floor muscle training on quality-adjusted life years (QALYs) in women with stress urinary incontinence treated by duloxetine

Eur J Obstet Gynecol Reprod Biol. 2021 Sep:264:25-30. doi: 10.1016/j.ejogrb.2021.06.025. Epub 2021 Jun 24.

Abstract

Objectives: The aim of this study was to measure the impact of innovative pelvic floor muscle training (iPFMT) on Quality-Adjusted Life Years (QALYs) in women with stress urinary incontinence (SUI) treated by duloxetine.

Study design: This analysis is part of the DULOXING study conducted between February 2019 and 2020. The control group received oral duloxetine treatment (40 mg BID), and the experimental group received oral duloxetine treatment (40 mg BID) and iPFMT with lumbopelvic stabilization. SUI was analysed at baseline and in the final period according to the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The QALYs gained were calculated by multiplying life expectancy (LE) by a weighting factor (QALYs = LE * WF).

Results: The study included 158 women, of whom 129 were fully analysed (81.6%). The mean life expectancy was 26.3 ± 11.8 years for the control group and 29.0 ± 11.7 years for the experimental group. The mean baseline ICIQ-UI SF scores were 15.2 ± 1.7 vs 15.1 ± 1.5, and the final ICIQ-UI SF scores were 9.8 ± 4.2 vs 8.3 ± 3.8, in the control vs the experimental group, respectively (p < 0.05). The mean baseline WF was 0.27 ± 0.08 vs 0.28 ± 0.07, and the final WF was 0.53 ± 0.20 vs 0.60 ± 0.18, in the control vs the experimental group, respectively (p < 0.05). Before treatment, the number of QALYs during life expectancy in the control vs the experimental group was 7.53 ± 4.24 vs 8.30 ± 4.01. The number of QALYs during life expectancy in control vs the experimental group increased following treatment: 15.03 ± 7.63 vs 17.90 ± 7.86 (p < 0.05).

Conclusions: Combination treatment with duloxetine and iPFMT statistically significantly increased the number of QALYs and reduced the degree of urinary incontinence in women with stress urinary incontinence.

Keywords: COVID-19; Duloxetine; Innovative pelvic floor muscle training; Quality-adjusted life years; Stress urinary incontinence.

MeSH terms

  • Duloxetine Hydrochloride / therapeutic use
  • Exercise Therapy
  • Female
  • Humans
  • Pelvic Floor
  • Quality of Life
  • Quality-Adjusted Life Years
  • Treatment Outcome
  • Urinary Incontinence, Stress* / drug therapy

Substances

  • Duloxetine Hydrochloride