Direct Full-stage Implantation of Sacral Neuromodulation

NCT ID: NCT03697954

Last Updated: 2020-10-14

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

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2021-05-31

Study Completion Date

2023-12-31

Brief Summary

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The purpose of this investigator-initiated study is to investigate the efficacy and costs of direct full stage sacral neuromodulation in patients with overactive bladder. Patients with refractory OAB and urge urinary incontinence will undergo direct full stage implantation and be followed for a period of 6 months to monitor symptom improvement with voiding diaries and validated questionnaires preoperatively and postoperatively. Therapeutic and adverse outcomes will be evaluated. The use of medical resources and time off of work will be analyzed as well. This will be a descriptive study with no additional arms or randomization.

Detailed Description

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Conditions

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Urinary Bladder, Overactive Urge Incontinence

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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overactive bladder patients

Female patients with refractory overactive bladder and urge urinary incontinence undergoing direct full stage implantation

full stage implantation of sacral neuromodulation

Intervention Type DEVICE

full stage implantation of sacral neuromodulation for overactive bladder and urge incontinence

Interventions

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full stage implantation of sacral neuromodulation

full stage implantation of sacral neuromodulation for overactive bladder and urge incontinence

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients \>18 years of age
* Female gender
* Refractory overactive bladder: wet failing treatment with two or more anticholinergic and/or beta-3 agonist agents
* Willing to stop treatment with anticholingeric and/or beta-3 agonist agents during the study period (2 week washout period preoperatively and 6 months postoperative)
* Willing and able to complete study questionnaires, use Medtronic device programmer, return for scheduled follow-up appointments
* Surgical candidate able to hold antiplatelet or anticoagulation prior to surgery
* Health insurance provider that will cover full-stage implantation

Exclusion Criteria

* Age \<18
* Pregnant or planning to become pregnant
* Male gender
* Unable or unwilling to stop anticholingeric and/or beta-3 agonist agents during the study period
* Treatment with botulinum toxin within last 6 months
* Recent surgery for stress urinary incontinence or pelvic organ prolapse within last 6 months
* Severe pelvic organ prolapse
* Post-void residual \>150 ml
* Symptomatic or recurrent urinary tract infection
* Neurologic disorders: cerebrovascular accident with neurologic deficits, Parkinson's, multiple sclerosis, spinal cord injury, significant peripheral neuropathy
* Cognitive disorders, e.g. dementia
* Interstitial cystitis or chronic pelvic pain syndrome
* Poorly controlled diabetes mellitus (HbA1c \>10%)
* History of bladder malignancy, pelvic radiation, urinary retention requiring catheterization
* Anticipated or known need for MRI at the trunk
* History of or anticipated surgery at the lower back
* Unable to hold antiplatelet or anticoagulation prior to surgery
* Life expectancy \<1 year
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Loma Linda University

OTHER

Sponsor Role lead

Responsible Party

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Andrea Staack

MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Loma Linda University Faculty Medical Offices

Loma Linda, California, United States

Site Status

Countries

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United States

References

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Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011 Oct;108(7):1132-8. doi: 10.1111/j.1464-410X.2010.09993.x. Epub 2011 Jan 13.

Reference Type BACKGROUND
PMID: 21231991 (View on PubMed)

Ganz ML, Smalarz AM, Krupski TL, Anger JT, Hu JC, Wittrup-Jensen KU, Pashos CL. Economic costs of overactive bladder in the United States. Urology. 2010 Mar;75(3):526-32, 532.e1-18. doi: 10.1016/j.urology.2009.06.096. Epub 2009 Dec 29.

Reference Type BACKGROUND
PMID: 20035977 (View on PubMed)

Coyne KS, Sexton CC, Irwin DE, Kopp ZS, Kelleher CJ, Milsom I. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008 Jun;101(11):1388-95. doi: 10.1111/j.1464-410X.2008.07601.x.

Reference Type BACKGROUND
PMID: 18454794 (View on PubMed)

Latini JM, Alipour M, Kreder KJ Jr. Efficacy of sacral neuromodulation for symptomatic treatment of refractory urinary urge incontinence. Urology. 2006 Mar;67(3):550-3; discussion 553-4. doi: 10.1016/j.urology.2005.09.066.

Reference Type BACKGROUND
PMID: 16527577 (View on PubMed)

Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, Das AK, Foster HE Jr, Scarpero HM, Tessier CD, Vasavada SP; American Urological Association; Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol. 2012 Dec;188(6 Suppl):2455-63. doi: 10.1016/j.juro.2012.09.079. Epub 2012 Oct 24.

Reference Type BACKGROUND
PMID: 23098785 (View on PubMed)

Other Identifiers

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5180114

Identifier Type: -

Identifier Source: org_study_id

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