Importance of anogenital distance parameters on duloxetine success in women with stress urinary incontinence.

Abstract

Objectives: To clarify the impact of anogenital distance (AGD) on duloxetine success in the management of women with stress urinary incontinence (SUI).

Material and methods: Patients who have been diagnosed with SUI, were evaluated for inclusion in the study. Distance between anus and clitoris (AGDAC), distance between anus and fourchette (AGDAF), and length of genital hiatus (GH) were measured. All patients started duloxetine 20 mg twice daily for 2 weeks, and then patients received 40 mg duloxetine twice daily. Patients were categorized into two groups (patients who benefited from duloxetine and patients who did not benefit from duloxetine). Patient characteristics and AGD parameters were compared between these two groups.

Results: In total, 178 women were included in study and mean duration of SUI was 2.9 years. The mean body mass index (BMI) was significantly higher in patients with unsuccessful therapy (p = 0.001). In contrast, nulliparous rate was significantly higher in patients who benefited from duloxetine (p = 0.043). The distance of AGDAC (71.4 mm vs 77.9 mm, p = 0.001) and distance of GH were significantly shorter (21.7 mm and 26.7 mm, p = 0.001) in patients who were successfully treated with duloxetine. Multivariate regression analysis found that BMI < 30 kg/m², shorter AGDAC, and GH lengths were significantly related with duloxetine success (p = 0.037, p = 0.036, and p = 0.039, respectively).

Conclusions: This study showed that duloxetine improved SUI in more than half of women and obesity was a predictive factor for duloxetine failure. In addition, shorter AGDAC length and shorter GH distance were significantly associated with duloxetine success in the management of SIU.