Lidocaine for Pessary Check Pain Reduction

NCT ID: NCT05493735

Last Updated: 2023-12-14

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

66 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-08

Study Completion Date

2023-06-30

Brief Summary

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The primary objective of this study is to estimate the effect of lidocaine jelly on patient pain at the time of office pessary removal.

Detailed Description

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The purpose of the study is to investigate the effects of lidocaine jelly on patient pain at the time of office pessary removal and reinsertion. All patients presenting to the University of South Florida Urogynecology clinic for a pessary maintenance appointment or "pessary check" will be screened as potential study participants. After being informed of risks and benefits of participation, informed consent will be obtained. Patients will be randomized into two groups: the control group or experimental group. The patient will complete a brief questionnaire and pain assessment using a Visual Analog Scale (VAS).

Patients will be blinded. The investigators will be unblinded. The investigators will apply the jelly (lidocaine vs lubricating). The participant will have an equal chance of being in the control arm or experimental arm. After 5 minutes, the investigator will assess the patient's genital hiatus with valsalva and proceed with pessary removal per the investigator's routine. The patient will complete another VAS to indicate pain level after pessary removal. The investigator will perform a speculum exam per routine and then reinsert the pessary. The patient will complete a final VAS to indicate level of pain after pessary reinsertion along with a brief final questionnaire.

Conditions

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Pelvic Organ Prolapse Stress Urinary Incontinence

Keywords

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Pessary Lidocaine Pain Reduction Pessary Check Pessary Removal Pessary Reinsertion Lubricating Jelly

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Control

Lubricating jelly (placebo) will be placed in the vagina to the level of the pessary, five minutes prior to pessary removal.

Group Type PLACEBO_COMPARATOR

Placebo Jelly

Intervention Type DRUG

Participants in the control arm will undergo pessary removal and reinsertion after the application of lubricating jelly.

Experimental

Lidocaine jelly will be placed in the vagina to the level of the pessary, five minutes prior to the pessary removal.

Group Type EXPERIMENTAL

Lidocaine Hcl 2% Jelly

Intervention Type DRUG

Participants in the experimental arm will undergo pessary removal and reinsertion after the application of lidocaine topical gel.

Interventions

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Lidocaine Hcl 2% Jelly

Participants in the experimental arm will undergo pessary removal and reinsertion after the application of lidocaine topical gel.

Intervention Type DRUG

Placebo Jelly

Participants in the control arm will undergo pessary removal and reinsertion after the application of lubricating jelly.

Intervention Type DRUG

Other Intervention Names

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Lidocaine Jelly Lubricating Gel Vaginal Lubricant

Eligibility Criteria

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Inclusion Criteria

* Women aged 18 years or older
* Presenting for routine pessary management for prolapse, stress urinary incontinence, or both with a pessary in place
* able to provide written informed consent
* able to complete the visual analog scale

Exclusion Criteria

* Women less than 18 years of age.
* Patients who speak neither English nor Spanish
* Pregnancy
* Medical contraindication to lidocaine
* Planned change in pessary size or type
* Patients who remove and reinsert their pessary at home
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of South Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Araba A Jackson, MD

Role: PRINCIPAL_INVESTIGATOR

University of South Florida

Locations

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USF Health Outpatient Urogynecology Clinics

Tampa, Florida, United States

Site Status

Countries

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United States

References

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Donnelly MJ, Powell-Morgan S, Olsen AL, Nygaard IE. Vaginal pessaries for the management of stress and mixed urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2004 Sep-Oct;15(5):302-7. doi: 10.1007/s00192-004-1163-7. Epub 2004 Aug 5.

Reference Type BACKGROUND
PMID: 15300365 (View on PubMed)

Nguyen JN, Jones CR. Pessary treatment of pelvic relaxation: factors affecting successful fitting and continued use. J Wound Ostomy Continence Nurs. 2005 Jul-Aug;32(4):255-61; quiz 262-3. doi: 10.1097/00152192-200507000-00010.

Reference Type BACKGROUND
PMID: 16030465 (View on PubMed)

Lone F, Thakar R, Sultan AH, Karamalis G. A 5-year prospective study of vaginal pessary use for pelvic organ prolapse. Int J Gynaecol Obstet. 2011 Jul;114(1):56-9. doi: 10.1016/j.ijgo.2011.02.006. Epub 2011 May 14.

Reference Type BACKGROUND
PMID: 21575953 (View on PubMed)

Taege SK, Adams W, Mueller ER, Brubaker L, Fitzgerald CM, Brincat C. Anesthetic Cream Use During Office Pessary Removal and Replacement: A Randomized Controlled Trial. Obstet Gynecol. 2017 Jul;130(1):190-197. doi: 10.1097/AOG.0000000000002098.

Reference Type BACKGROUND
PMID: 28594757 (View on PubMed)

Keskin AE, Onaran Y, Duvan IC, Simavli S, Kafali H. Topical anesthetic (lidocaine-prilocaine) cream application before speculum examination in postmenopausal women. J Minim Invasive Gynecol. 2012 May-Jun;19(3):350-5. doi: 10.1016/j.jmig.2012.01.005. Epub 2012 Mar 13.

Reference Type BACKGROUND
PMID: 22417905 (View on PubMed)

Ozel BZ, Sun V, Pahwa A, Nelken R, Dancz CE. Randomized controlled trial of 2% lidocaine gel versus water-based lubricant for multi-channel urodynamics. Int Urogynecol J. 2018 Sep;29(9):1297-1302. doi: 10.1007/s00192-018-3576-8. Epub 2018 Feb 17.

Reference Type BACKGROUND
PMID: 29455237 (View on PubMed)

Other Identifiers

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Pro004522

Identifier Type: -

Identifier Source: org_study_id