Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Prevention of incontinence after delivery
- Max Mongelli (31 May 2002)
|
|
|||
|
Max Mongelli, Associate Professor/Consultant Obstetrician and Gynecologist Dept. Obstetrics and Gynecology, National University Hospital, Singapore,119074
Send response to journal:
|
Editor, I read with interest the recent article by Chiarelli and Cockburn on promoting urinary continence in women after delivery [1]. The study suggested a marginal reduction in incontinence at 3 months post-partum after active intervention by a physiotherapist. I would like to point out some methodological issues that need to be addressed in this trial. Although presented as a randomised trial, the authors did not describe the method of randomisation. An inappropriate randomisation process can easily introduce bias in the results. Furthermore, the design of the study is such that a placebo effect from simply talking to a physiotherapist cannot be ruled out – ideally women in the control group should have been seen by a physiotherapist (without active intervention) with equal frequency. An important confounder which was not described in the paper is the number of women in the control group who attended the routine post-natal physiotherapy classes held in the ward. These were offered to all women post-partum. A significant number of such attendances may have led to an underestimate of the effect of active intervention. It is hoped that future studies on the prevention of post-partum urinary incontinence will take these factors into consideration. 1. BMJ 2002;324:1241 Max Mongelli
|
|||