Filocamo 2005.
Methods | Randomised: yes
Method of allocation: block randomisation, block size of 4 for 2 groups (A and B) with only one permutation code (ABBA) Blinding: not described Dropouts: at 12 months, 2 participants dropped out of the control group Intention to treat: yes |
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Participants | Recruitment: post‐operative Included: all men undergoing RRP N = 300 consecutive men post RRP, randomised after catheter removal to 2 groups Intervention group: N = 150 Control group: N = 150 |
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Interventions | Post‐operative intervention Group A (150) intervention: formal instruction (3 treatment sessions plus at home exercises) in PFMT using verbal explanation, palpation and visualization of the base of the penis with a mirror, in different positions and prior to sneezing, coughing or lifting Group B (150) control: no formal instruction Length of follow‐up: 12 months |
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Outcomes | Main outcome: urine loss on 1 hour and 24 hour pad tests plus number of pads used daily Continence definition: 0 to 1 pads per day Data collection: 1, 3, 6, and 12 months Wet (leakage or use of pads) 1 month: A 145/150, B 147/150 3 months: A 115/150, B 129/150 6 months: A 35/150, B 102/150 12 months: A 16/150, B 49/148 Surgical implantation of artificial urinary sphincter: A 2/150, B 3/148 |
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Notes | 74% of the intervention group achieved continence at 3 months compared to only 30% of the control (a significant difference favouring intervention) Differences between the groups declined between 6 to 12 months, with most participants achieving continence in 1 year |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Block randomisation, block size of 4 for 2 groups (A and B) with only one permutation code (ABBA) |
Allocation concealment (selection bias) | Unclear risk | Not stated. Therefore judged to be unclear risk |
Blinding of participants (performance bias) | High risk | Blinding to intervention not possible |
Blinding of personnel (performance bias) | High risk | Blinding to intervention not possible |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | No description of blinding of pad test or data entry from questionnaires |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 2 dropped out of control group but none from intervention |
Selective reporting (reporting bias) | Unclear risk | Protocol not available |
Financial support | Unclear risk | Not reported. Therefore judged to be unclear risk |
Approved by medical ethics committee | Low risk | "Approved by the Ethics Committee of our Institution" |
Informed consent | Low risk | "All patients signed an informed consent form" |
ITT analysis | Unclear risk | Not specified |