Overnight Bladder Drainage and Posterior Urethral Valve Sequelae

NCT ID: NCT05168358

Last Updated: 2021-12-23

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

55 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-12

Study Completion Date

2023-06-12

Brief Summary

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We hypothesize that overnight catheter drainage (OCD) of the urinary bladder might improve bladder dynamics and subsequently lead to improvement or resolution of hydronephrosis (HN) and renal function in boys who underwent PUV ablation.

Patients who have persistent HN and bladder dysfunction at least one year after PUV ablation will be randomly allocated into two groups: the first group (control group): 55 patients, their parents will be taught the timed voiding regimen every 2 hours, while the second group (OCD group): 55 patients, their parents will be taught the timed voiding regimen every 2 hours, in addition to placing an overnight catheter to drain the urinary bladder during night.

We will study the effect of OCD of the urinary bladder on the improvement or resolution of HN and urinary bladder function within a year of starting this regimen.

Detailed Description

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Posterior urethral valve (PUV) is the most common cause of bladder outlet obstruction (BOO) in boys. PUV induces damage to the smooth muscles of the bladder and ureter with subsequent damage to the renal parenchyma. All these sequelae begin antenatally and persist even after successful valve ablation.

The standard management of these sequelae includes timed voiding, double voiding, clean intermittent catheterization (CIC) to facilitate bladder emptying and anticholinergic drugs to improve poor bladder compliance. However, in some polyuric cases even voiding or catheterization as frequently as every 2 hours is not effective to maintain safe bladder volumes especially at night.

Overnight catheter drainage (OCD) of the urinary bladder has been increasingly suggested to be beneficial in protecting the upper tracts of patients with high urine output, defective and poorly compliant bladders, thus resulting in improvement of the renal function, hydronephrosis (HN) and the urodynamic changes as well.

Therefore, we hypothesize that OCD of the urinary bladder might improve bladder dynamics and subsequently lead to improvement or resolution of HN and renal function in boys who underwent PUV ablation.

Patients who have persistent HN and bladder dysfunction at least one year after PUV ablation will be randomly allocated into two groups: the first group (control group): 55 patients, their parents will be taught the timed voiding regimen every 2 hours, while the second group (OCD group): 55 patients, their parents will be taught the timed voiding regimen every 2 hours, in addition to placing an overnight catheter to drain the urinary bladder during night.

We will study the effect of OCD of the urinary bladder on the improvement or resolution of HN and urinary bladder function within a year of starting this regimen by laboratory tests, renal and bladder ultrasonography (US), voiding cystourethrogram (VCUG) and dimercaptosuccinic acid (DMSA) scan. The bladder dynamics will also be examined by urodynamic study (UDS).

Conditions

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Posterior Urethral Valve

Keywords

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Overnight Catheter Drainage Posterior Urethral Valve Randomized Controlled Trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control group

This arm will include 55 patients, their parents will be taught the timed voiding regimen every 2 hours.

Group Type NO_INTERVENTION

No interventions assigned to this group

OCD group

This arm will include 55 patients, their parents will be taught the timed voiding regimen every 2 hours, in addition to placing an overnight catheter to drain the urinary bladder during night.

Group Type EXPERIMENTAL

Overnight Bladder Drainage

Intervention Type PROCEDURE

Parents or caregivers of the patients will be taught to place an indwelling catheter in the bladder at bedtime for about 8-12 h under a clean technique every night for one year. The catheter will then be allowed to drain freely into a gravity drainage collecting bag or in the diapers. On the next morning, the catheter will be removed and the timed voiding regimen will be resumed.

Interventions

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Overnight Bladder Drainage

Parents or caregivers of the patients will be taught to place an indwelling catheter in the bladder at bedtime for about 8-12 h under a clean technique every night for one year. The catheter will then be allowed to drain freely into a gravity drainage collecting bag or in the diapers. On the next morning, the catheter will be removed and the timed voiding regimen will be resumed.

Intervention Type PROCEDURE

Other Intervention Names

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Overnight Catheter Drainage

Eligibility Criteria

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Inclusion Criteria

* Persistent hydronephrosis and
* Unfavorable bladder dynamics on urodynamic study performed at least one year after posterior urethral valve ablation will be included in the study. The unfavorable bladder dynamics will be defined as poor compliance or detrusor overactivity.

Exclusion Criteria

* Underwent urinary diversion (e.g. vesicostomy or ureterostomy),
* Have other conditions that could affect lower urinary tract function,
* Have infravesical obstruction or
* Those who will refuse to participate in the study will be excluded.
Minimum Eligible Age

1 Year

Maximum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Mansoura University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Elkashef

Ahmed Elkashef

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed Elkashef

Role: PRINCIPAL_INVESTIGATOR

Urology and Nephrology Center, Mansoura University, Egypt

Ahmed Abdelhalim

Role: STUDY_DIRECTOR

Urology and Nephrology Center, Mansoura University, Egypt

Ashraf Hafez

Role: STUDY_DIRECTOR

Urology and Nephrology Center, Mansoura University, Egypt

Mohamed Dawaba

Role: STUDY_DIRECTOR

Urology and Nephrology Center, Mansoura University, Egypt

Locations

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Urology and Nephrology Center

Al Mansurah, DK, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Ahmed Elkashef

Role: CONTACT

Phone: 01000428981

Email: [email protected]

Ahmed Abdelhalim

Role: CONTACT

Phone: 01020245496

Email: [email protected]

Facility Contacts

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Ahmed Elkashef

Role: primary

Ahmed Abdelhalim

Role: backup

Other Identifiers

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OCD-PUV

Identifier Type: -

Identifier Source: org_study_id