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Obstetrics and gynaecology
Research
Use of symptom-relieving drugs before and after surgery for urinary incontinence in women: a cohort study
  1. Rikke Guldberg1,2,
  2. Søren Brostrøm3,
  3. Ulrik Schiøler Kesmodel4,
  4. Linda Kærlev1,2,
  5. Jesper Kjær Hansen1,2,
  6. Jesper Hallas5,
  7. Bente Mertz Nørgård1,2
  1. 1Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
  2. 2Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
  3. 3Department of Hospital Services and Emergency Management, Danish Health and Medicines Authority, Copenhagen, Denmark
  4. 4Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
  5. 5Research Unit of Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
  1. Correspondence to Dr Rikke Guldberg; Rikke.Guldberg.Soerensen{at}rsyd.dk

Abstract

Objective To describe the use of symptom-relieving drugs (antimuscarinic drugs or duloxetine) before and after surgery for urinary incontinence (UI); and for those with use of antimuscarinic drugs or duloxetine before surgery, to estimate the risk of being a postoperative user, relative to those without use before surgery.

Design A historical population-based cohort study.

Setting Denmark.

Participants Women ≥18 years with a first-time surgical procedure for UI from the county of Funen, Denmark between 1 January 1996 and 31 December 2006, extended to the Region of Southern Denmark from 1 January 2007 to the end of 2010. For these women, data on redeemed prescriptions ±365 days of date of surgery were extracted.

Main outcome measures Effect of preoperative use of antimuscarinic drugs or duloxetine on the risk of being a postoperative user of these drugs.

Results Of 2151 women with a first-time surgical procedure for UI, 358 (16.6%) were preoperative users of antimuscarinic drugs or duloxetine and 1793 were not (83.4%). A total of 110 (30.7%) of the preoperative users also redeemed prescriptions for these drugs within 0–60 days after surgery, and 152 (42.5%) of the preoperative users redeemed prescriptions for these drugs within 61–365 days after surgery. Among preoperative non-users, 25 (1.4%) and 145 (8.1%) redeemed prescriptions within 0–60 and 61–365 days after surgery, respectively. Presurgery exposure to antimuscarinic drugs or duloxetine was a strong risk factor of postoperative drug use, both within 0–60 days (adjusted OR=33.0, 95% CI 20.0 to 54.7) and 61–365 days (OR=7.2, 95% CI 5.4 to 9.6).

Conclusions A substantial number of women will continue to be prescribed symptom-relieving drugs after surgery for UI within a year of follow-up. Only a minority of preoperative non-users initiated usage of symptom-relieving drugs after surgery. Compared with other factors included in the regression model, preoperative use of antimuscarinic drugs or duloxetine was the strongest risk factor for postoperative use.

  • Urinary incontinence
  • Antimuscarinic drugs
  • SURGERY
  • Clinical epidemiology
  • Duloxetine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi-org.ezproxy.u-pec.fr/10.1136/bmjopen-2013-003297

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