Safety and Efficacy of PVDF (DynaMesh®-SIS Soft) Retropubic Midurethral Slings in Stress Urinary Incontinence in Women

NCT ID: NCT02407145

Last Updated: 2023-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

218 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-03-31

Study Completion Date

2021-04-01

Brief Summary

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This study is designed to evaluate the safety and efficacy of low elasticity polyvinylidene fluoride (DynaMesh®-SIS soft) retropubic tension-free midurethral slings in the treatment of stress urinary incontinence in women. Women who are having a retropubic PVDF midurethral sling for urodynamic stress incontinence will be followed up for 24 months to address its efficacy and rate of complications.

Detailed Description

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This study is designed to evaluate the safety and efficacy of low elasticity polyvinylidene fluoride (DynaMesh®-SIS soft) retropubic tension-free midurethral slings in the treatment of stress urinary incontinence (SUI) in women.

Stress urinary incontinence is a common problem, affecting large numbers of women. If conservative measures are ineffective then surgery is offered. Surgery involves a permanent mesh sling being placed, tension free beneath the midurethra. The standard retropubic tension-free vaginal tape (TVT) has been used since 1996 using a polypropylene mesh.(1) The use of permanent mesh in gynaecology has come under scrutiny due to significant complications for women.(2) This year the Medicines and Healthcare Products Regulatory Agency (MHRA), UK concluded that there is not enough evidence to withdraw mesh from clinical usage.(3)

The sling being studied is DynaMesh®SIS soft, made of polyvinylidene fluoride (PVDF) which has improved biocompatibility with tissues, meaning reduced scar formation and less mesh shrinkage.(4) Each sling is individually woven and and has low elasticity meaning dimensions are maintained under tension, such as with coughing or straining. The technique of retropubic placement of the DynaMesh®SIS soft does not differ from current retropubic TVT placement.

The hypothesis is that the low elasticity polyvinylidene fluoride midurethral sling is non-inferior in both safety and efficacy compared with the safety and efficacy of traditional polypropylene slings, as reported in current literature.

There are eleven research centres in two countries, The United Kingdom and Ireland. The DynaMesh®SIS soft sling is currently in use in four of eleven of the research hospitals, Norwich (main research centre), Antrim and Belfast in the UK and in Munich in Germany. It will be introduced in London, Cambridge, Wirral, Solihull, Huntingdon and Kilmarnock in the UK and Wurzbug in Germany.

Women with urodynamic stress incontinence who are already assigned to have this retropubic midurethral tape placed for treatment will be recruited prior to their procedure for ongoing follow up. Participants will complete standardised urinary incontinence and quality of life questionnaires prior to their procedure and at 3,6,12, 18 and 24 months by post. Clinical follow up will occur at 3 and 12 months post operatively and as required if any concerns.

Conditions

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Urinary Stress Incontinence Urinary Incontinence,Stress

Keywords

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retropubic midurethral sling polyvinylidene fluoride

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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PVDF retropubic midurethral sling

Women with urodynamic stress urinary incontinence having a retropubic polyvinylidene fluoride midurethral sling (DynaMesh®-SIS soft).

24 month follow up of women with validated questionnaire

Intervention Type OTHER

24 month follow up (clinical and questionnaire based) of women who are already assigned to have a PVDF retropubic midurethral sling (DynaMesh®-SIS soft) as a part of their planned treatment of urodynamic stress incontinence.

Interventions

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24 month follow up of women with validated questionnaire

24 month follow up (clinical and questionnaire based) of women who are already assigned to have a PVDF retropubic midurethral sling (DynaMesh®-SIS soft) as a part of their planned treatment of urodynamic stress incontinence.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* women with proven urodynamic stress incontinence in whom a retropubic midurethral sling is appropriate treatment as per the treating urogynaecologist, gynaecologist or urologist
* women who have not had a previous incontinence procedure
* no concomitant prolapse procedure at the time of sling placement

Exclusion Criteria

* urodynamic studies negative for stress urinary incontinence
* previous incontinence procedures
* non English/non German speaker depending on study centre
* lack capacity to consent
Minimum Eligible Age

20 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Kebomed UK

UNKNOWN

Sponsor Role collaborator

Julie Dawson

OTHER

Sponsor Role lead

Responsible Party

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Julie Dawson

Research Services Manager

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Sambit Mukhopadhyay

Role: PRINCIPAL_INVESTIGATOR

Norfolk and Norwich University Hospital Trust

Edward P Morris

Role: STUDY_CHAIR

Norfolk and Norwich University Hospital Trust

Locations

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Chirurgische Klinik

Munich, , Germany

Site Status

Universitätsklinikum Würzburg

Würzburg, , Germany

Site Status

Hichingbooke Hospital

Huntingdon, Cambridgeshire, United Kingdom

Site Status

Addenbrooke's Hospital

Cambridge, Cambrigeshire, United Kingdom

Site Status

South Eastern Health and Social Care Trust

Belfast, , United Kingdom

Site Status

NHS Ayrshire & Arran

Kilmarnock, , United Kingdom

Site Status

University College Hospital

London, , United Kingdom

Site Status

Wirral University Teaching Hospital NHS Foundation

Metropolitan Borough of Wirral, , United Kingdom

Site Status

Norfolk and Norwich University Hospitals Trust

Norwich, , United Kingdom

Site Status

Heart of England NHS Foundation Trust

Solihull, , United Kingdom

Site Status

Countries

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Ireland Germany United Kingdom

References

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Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1996;7(2):81-5; discussion 85-6. doi: 10.1007/BF01902378.

Reference Type BACKGROUND
PMID: 8798092 (View on PubMed)

U.S. FDA Safety Communication: urogynecologic surgical mesh: update on the safety and effectiveness of transvaginal placement for pelvic organ prolapse. July 2011

Reference Type BACKGROUND

A summary of the evidence on the benefits and risks of vaginal mesh implants. October 2014. Medicines and Healthcare Products Regulatory Agency, United Kingdom.

Reference Type BACKGROUND

Klinge U, Binneboesel M, Kuschel S, Schuessler B. Demands and properties of alloplastic implants for the treatment of stress urinary incontinence. Expert Rev Med Devices. 2007 May;4(3):349-59. doi: 10.1586/17434440.4.3.349.

Reference Type BACKGROUND
PMID: 17488229 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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2015O&G01M

Identifier Type: -

Identifier Source: org_study_id