Urge urinary incontinence (UUI) and fecal incontinence (FI) frequently co-exist. Despite similar pathophysiology between the two conditions, there is no current evidence to support improvement of FI symptoms from medical treatment of UUI. Darifenacin is used to treat UUI, and it is known to have the most constipating properties among antimuscarinic drugs. This study evaluated the effect of darifenacin on FI symptoms when being used for UUI among patients with double incontinence.
In this prospective cohort study, 32 women suffering from primarily UUI with concomitant FI were selected based on UDI-6 and St. Mark’s questionnaires and elected for antimuscarinic therapy. Participants were treated with 15 mg of darifenacin for 8 weeks after completion of UDI-6, St. Mark’s (Vaizey), Fecal Incontinence Quality of Life (FIQL) score, Overactive Bladder Questionnaire short form (OAB-q), and a 7-day bowel diary with the Bristol Stool Scale. Interviews were performed at 4 and 8 weeks, with a full set of questionnaires, bowel diary and Patient Global Impression of Improvement (PGI-I) performed at the last visit. Among the 87.5% (28/32) of women who completed the study, St. Mark’s (Vaizey) and FIQL scores were significantly improved. The number of weekly continent bowel movements and consistency of bowel movements did not change significantly. However, the number of stool incontinent episodes, number of continent days per week, and fecal urgency significantly improved. UUI symptoms demonstrated significant improvement without an increase in serious side effects. Notably, 51.9% of participants chose to continue darifenacin therapy after completion of the study.
This study showed that using darifenacin in women suffering from double incontinence significantly improves both FI and UUI symptoms with positive impact on quality of life.
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Dubinskaya, A. Commentary: effect of darifenacin on fecal incontinence in women with double incontinence. Int Urogynecol J (2020). https://doi.org/10.1007/s00192-020-04387-1