Preoperatively BAMs were used in 40% of DTtX
patients and 50% of DT patients. Most patients in
both groups were able to safely stay off BAMs during
the study period. However, by the end of the
study 2 patients in both groups chose to return to
BAM use.
One patient in each group used CIC before the study
and did not need to use CIC after completion of the
study (supplementary Appendix 2, http://jurology.
com/). However, most patients in both groups who
were using CIC before the study chose to return to
CIC when the study was complete.
Xiao：
The authors tried to cover up the defect by twice stating in the article that “CIC and the use of BAMs [bladder-active medications] were terminated 2 weeks prior to preoperative evaluations, and most patients were able to refrain from both of these modalities for the entire 3-year follow-up.” This statement completely invalidated the scientific and methodological grounds of this so-called double-blind study: postoperative care must be strictly the same in all patients, i.e., either all should use CIC and the same dosage of BAMs, or all should not use CIC and BAMs. How many patients was “most”: 11, 15, 18? The authors did not report these critical and most important data. But nevertheless, it was fundamentally wrong to paralyze the bladders of some patients using BAMs while not paralyzing those of other patients during postoperative follow-ups in a double-blind trial, and then collect and analyze their data together.