Clinical outcomes and safety of duloxetine and tolterodine combination in the treatment of mixed-type urinary incontinence: A single-arm retrospective study

Objective : This study aimed to evaluate the clinical outcomes and safety of combined duloxetine and tolterodine therapy in patients with mixed urinary incontinence. Methods: A retrospective analysis was conducted on patients with mixed urinary incontinence treated between January 2021 and December 2023. Patients received tolterodine (4 mg/day) and duloxetine (40 mg twice daily). Clinical outcomes were assessed at weeks 4 and 12 using the Overactive Bladder Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, pad tests, and bladder diaries. Patient satisfaction was evaluated using the Clinical Global Impression scale. Results: The study included 115 patients (mean age: 46.6 +/- 13.4 years). Significant improvements were observed in Overactive Bladder Symptom Score, International Consultation on Incontinence Questionnaire-Short Form scores, and pad weights at weeks 4 and 12 compared to baseline (p < 0.001). Daily micturition, nocturia, urgency, and incontinence episodes significantly decreased, whereas mean voided volume increased. According to Clinical Global Impression scores, 73.9% of patients reported partial or complete improvement. Treatment-related adverse events were observed in 12.1% of patients. Conclusion: The combination therapy of duloxetine and tolterodine appears to be safe and potentially beneficial, reducing symptom scores and incontinence episodes. However, these findings need to be supported by controlled studies.