Sacral Nerve Stimulation Therapy for the Treatment of Chronic Fecal Incontinence

NCT ID: NCT00200057

Last Updated: 2013-01-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

285 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-01-31

Study Completion Date

2011-09-30

Brief Summary

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Fecal incontinence (FI) is a difficulty in storing gas, liquid stool or solid stool (bowel movement) in order to expel it at a proper time and place. Patients who suffer from FI may experience passive FI (difficulty in sensing stool in the rectum) or urgency (able to sense a bowel movement but cannot hold the stool until an acceptable time and place). FI is not a life-threatening disease, but it is often profoundly distressing and socially incapacitating.

If a patient is suffering with symptoms of chronic FI despite trying oral medications, biofeedback and/or other more conservative treatments, a patient may be eligible to participate in a clinical research study to evaluate the safety and effectiveness of sacral nerve stimulation for the treatment of chronic fecal incontinence. One hundred-twenty (120) patients will be implanted with medical devices and followed closely for twelve months, and then once a year after that until the study closes. There are up to 20 centers in the United States.

Detailed Description

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Conditions

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Fecal Incontinence

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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InterStim Sacral Nerve Stimulation Therapy

Open label study. All subjects that qualify for the study will be implanted.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Signed and dated informed consent.
* 18 years of age or older.
* Patient is diagnosed with chronic fecal incontinence of a duration greater than 6 months (\>12 months post-vaginal childbirth) and defined as \> 2 incontinent episodes on average per week of more than staining recorded during the baseline diary period.
* Failed or are not candidates for more conservative treatments.
* Willing and competent to completely and accurately fill out bowel diaries and questionnaires throughout the study.

Exclusion Criteria

* Congenital anorectal malformations.
* Active participation in another bowel disorder investigational study.
* Present rectal prolapse.
* Previous rectal surgery (such as rectopexy or resection) or sphincteroplasty done \< 12 months prior to study enrollment (24 months for cancer).
* Neurological diseases such as clinically significant peripheral neuropathy or complete spinal cord injury (i.e. paraplegia).
* Grade III hemorrhoids.
* Known or suspected organic disorders of the bowel (i.e. Inflammatory bowel disease such as Crohn's or ulcerative colitis).
* Chronic watery diarrhea, unmanageable by drugs or diet, as primary cause of fecal incontinence. (Incontinent episodes with a Bristol stool consistency of \> 6 for \> 4 days during the baseline diary period will be exclusionary, unless the investigator determines that the diary is not indicative of chronic watery diarrhea.)
* Pregnancy or planned pregnancy.
* Patients for whom patient materials are not available in a language understood by the patient.
* Life expectancy of less than one year.
* Patient characteristics indicating a poor understanding of the study or poor compliance with the study protocol (i.e., patients unable to adequately operate equipment, patients unwilling or unable to return for scheduled follow-up visits).
* Patients with a history of pelvic irradiation who present with visible or functional effects of irradiation.
* Patients with active anal abscesses or fistulas.
* Patients with anatomical limitations that would prevent the successful placement of an electrode.
* Patients with knowledge of planned MRIs, diathermy, microwave, or RF energy.
* Patients with other implantable neurostimulators, pacemakers or defibrillators.
* Defect of external anal sphincter of \>60 degrees or amenable to surgical repair.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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MedtronicNeuro

INDUSTRY

Sponsor Role lead

Responsible Party

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Medtronic

Principal Investigators

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Sudha Iyer, PhD

Role: STUDY_DIRECTOR

Medtronic

Locations

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Los Angeles, California, United States

Site Status

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San Francisco, California, United States

Site Status

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Washington D.C., District of Columbia, United States

Site Status

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Weston, Florida, United States

Site Status

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Chicago, Illinois, United States

Site Status

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Kansas City, Kansas, United States

Site Status

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New Orleans, Louisiana, United States

Site Status

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Burlington, Massachusetts, United States

Site Status

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Minneapolis, Minnesota, United States

Site Status

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Cleveland, Ohio, United States

Site Status

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Oklahoma City, Oklahoma, United States

Site Status

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Fort Worth, Texas, United States

Site Status

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Fleurimont, Quebec, Canada

Site Status

Countries

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United States Canada

References

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Wexner SD, Coller JA, Devroede G, Hull T, McCallum R, Chan M, Ayscue JM, Shobeiri AS, Margolin D, England M, Kaufman H, Snape WJ, Mutlu E, Chua H, Pettit P, Nagle D, Madoff RD, Lerew DR, Mellgren A. Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg. 2010 Mar;251(3):441-9. doi: 10.1097/SLA.0b013e3181cf8ed0.

Reference Type RESULT
PMID: 20160636 (View on PubMed)

Wexner SD, Hull T, Edden Y, Coller JA, Devroede G, McCallum R, Chan M, Ayscue JM, Shobeiri AS, Margolin D, England M, Kaufman H, Snape WJ, Mutlu E, Chua H, Pettit P, Nagle D, Madoff RD, Lerew DR, Mellgren A. Infection rates in a large investigational trial of sacral nerve stimulation for fecal incontinence. J Gastrointest Surg. 2010 Jul;14(7):1081-9. doi: 10.1007/s11605-010-1177-z. Epub 2010 Mar 31.

Reference Type RESULT
PMID: 20354809 (View on PubMed)

Other Identifiers

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G010206

Identifier Type: -

Identifier Source: org_study_id

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