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To gain clinical experience with the GreenLight HPS System, a system designed to vaporize and coagulate tissue in the treatment of benign prostatic hyperplasia to reduce lower urinary tract symptoms.
Enlarged prostate or Benign Prostatic Hyperplasia (BPH) is one of the most common diseases of aging men and can be associated with lower urinary tract symptoms (LUTS) such as having to urinate very often, a sudden strong feeling of having to urinate, having to get up at night to urinate, decreased and intermittent force of stream and the feeling of incomplete bladder emptying. These symptoms affect quality of life by interfering with normal daily activities and sleep patterns. When surgery is the best treatment option for the patient, the most common technique is a "transurethral resection of the prostate" (TURP). TURP involves removing the some of the extra tissue of the prostate gland. Even though TURP is a good treatment, there are concerns about the frequency of complications following treatment as well as the significant costs to patients, doctors, and insurance providers.
Photoselective vaporization of the prostate (PVP) is a relatively new technology that has similar benefits with fewer side effects than TURP. PVP is a minimally invasive procedure that uses a special high-energy laser to eliminate excess prostate tissue and seal the treated area. This technology has been used for more than a decade with over 200,000 procedures performed worldwide.
The focus of this study is to 1) document the long-term advantages of GreenLight HPS 120w and 2) to show that the stronger laser is a more flexible and efficient device which allows for a shorter procedure time, may be done in an out-patient setting in healthy patients, allows for shorter catheterization time, may result in a rapid urinary flow rate with minimal side effects, and may allow a quick return to normal activities. This device has been approved by the United States Food and Drug Administration (FDA) for treatment of obstructive BPH.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GreenLight HPS | Other |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GreenLight HPS | Device | Greenlight HPS laser system for treatment of BPH |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants With Treatment Success | Treatment success is determined on a per patient basis and is defined as [(baseline I-PSS - I-PSS at 6-months)/ baseline I-PSS] greater than or equal to 50% | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment-related Complication | Treatment-related events include the following:
|
| Measure | Description | Time Frame |
|---|---|---|
| Length of Hospital Stay (LOS) | Defined as the time from admission to the healthcare facility until discharge (in hours). | Peri-Operative Period |
| Length of Catheterization (LOC) | Defined as the time the subject required an indwelling Foley catheter post treatment (in hours). |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Claus G Roehrborn, MD | UT Southwestern Medical Center at Dallas | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCLA | Los Angeles | California | 90095 | United States | ||
| Connecticut Clinical Reseach Center |
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This study enrolled patients at least 45 years of age with symptomatic/obstructive BPH for at least 3 months and requiring surgical intervention. Enrollment occurred at 10 academic and private medical centers in the US. The last patient follow up visit was completed in August 2012. The last site close-out visit was completed January 2013.
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| ID | Title | Description |
|---|---|---|
| FG000 | GreenLight HPS Laser System | GreenLight HPS Laser System therapy for patients with BPH. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| 3 months |
| Percentage of Participants With Clinically-significant Improvement in Uroflow. | A clinically significant improvement in uroflow is defined as an increase in peak urinary flow rate (Qmax) of at least five ml/sec from baseline to 6 months | 6 months post-treatment |
| Percentage of Participants With Clinically-significant Improvement in Post-void Residual Urine Volume. | A clinically significant improvement in post-void residual is defined as a decrease of at least 50ml from baseline to 6 months. | 6 months post-treatment |
| Quality of Life Score (QoL) From I-PSS From Baseline Through 5 Years. | Participant response to the question "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?". Values range from 0 ("Delighted") to 6 ("Terrible") with higher values indicating worse outcomes. | 5 years |
| Gross Hematuria | Kaplan-Meier estimate of percentage of participants who require a blood transfusion as a result of hematuria. | 91 days |
| Percentage of Participants With Treatment Success | Treatment success is determined on a per patient basis and is defined as a 50% or greater decrease in IPSS from baseline to the specified time point. | 5 Years |
| Length of Time to Return to Pre-treatment Level of Physical Activity (in Days), Excluding Sexual Activity. | Up to five years |
| Occurrence of Retrograde Ejaculation | Kaplan-Meier estimate of percentage of participants who experience retrograde ejaculation. | 5 Year Follow Up |
| Recovery Period |
| Length of Procedure (LOP) | Defined as the time from cystoscope insertion into the urethra to the time of cystoscope removal (in minutes). | Procedure |
| Length of Lasing (LOL) | Total time the laser was on during the study procedure. | Procedure |
| Number of Fibers Used During Procedure | Procedure |
| Total Joules Used | Total energy applied during the study procedure | Procedure |
| Middlebury |
| Connecticut |
| 06762 |
| United States |
| North Fulton Urology, P.C. | Roswell | Georgia | 30076 | United States |
| Affiliates in Urology | Detroit | Michigan | 48186 | United States |
| PC Group/Universtiy Urology Association | New York | New York | 10016 | United States |
| Glickman Urological Institute | Cleveland | Ohio | 44195 | United States |
| Oklahoma University Health Science Center_Urology | Oklahoma City | Oklahoma | 73104 | United States |
| UT Southwestern Medical Center at Dallas | Dallas | Texas | 75390-9110 | United States |
| Urology of Virginia | Virginia Beach | Virginia | 23454 | United States |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | GreenLight HPS Laser System | GreenLight HPS Laser System therapy for patients with BPH. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| Height (cm) | Mean | Standard Deviation | cm |
| |||||||||||||||||
| Weight (kg) | Mean | Standard Deviation | kg |
| |||||||||||||||||
| Smoker | Number | participants |
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| Previous BPH Treatment | Number | participants |
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| Average Duration of Obstructive Symptoms (months) | Mean | Standard Deviation | months |
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| Peak Flow Rate (ml/sec) | Mean | Standard Deviation | ml/sec |
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| Post-void Residual Volume (ml) | Mean | Standard Deviation | ml |
| |||||||||||||||||
| Serum Prostate Specific Antigen (PSA) level (ng/ml) | Mean | Standard Deviation | ng/ml |
| |||||||||||||||||
| Prostate Volume (cc) | Mean | Standard Deviation | cc |
| |||||||||||||||||
| International Prostate Symptom Score (IPSS) at Baseline | The IPSS measures the severity of BPH symptoms and is calculated as the sum of 7-items from a participant-administered instrument. The IPSS ranges from 0 (asymptomatic) to 35 (severely symptomatic) with higher values indicating a worse condition. | Mean | Standard Deviation | Scores on a scale |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percentage of Participants With Treatment Success | Treatment success is determined on a per patient basis and is defined as [(baseline I-PSS - I-PSS at 6-months)/ baseline I-PSS] greater than or equal to 50% | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Number | percentage of participants | 6 months |
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| Secondary | Treatment-related Complication | Treatment-related events include the following:
| Participants who received the study treatment. | Posted | Number | 95% Confidence Interval | percentage of subjects with complication | 3 months |
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| Secondary | Percentage of Participants With Clinically-significant Improvement in Uroflow. | A clinically significant improvement in uroflow is defined as an increase in peak urinary flow rate (Qmax) of at least five ml/sec from baseline to 6 months | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Number | 95% Confidence Interval | percentage of patients improved | 6 months post-treatment |
|
| |||||||||||||||||||||||||||
| Secondary | Percentage of Participants With Clinically-significant Improvement in Post-void Residual Urine Volume. | A clinically significant improvement in post-void residual is defined as a decrease of at least 50ml from baseline to 6 months. | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Number | 95% Confidence Interval | percentage of patients improved | 6 months post-treatment |
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| Secondary | Quality of Life Score (QoL) From I-PSS From Baseline Through 5 Years. | Participant response to the question "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?". Values range from 0 ("Delighted") to 6 ("Terrible") with higher values indicating worse outcomes. | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | Score on a scale | 5 years |
| ||||||||||||||||||||||||||||
| Secondary | Gross Hematuria | Kaplan-Meier estimate of percentage of participants who require a blood transfusion as a result of hematuria. | Participants who received the study treatment | Posted | Number | Percentage of subjects | 91 days |
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| ||||||||||||||||||||||||||||
| Secondary | Percentage of Participants With Treatment Success | Treatment success is determined on a per patient basis and is defined as a 50% or greater decrease in IPSS from baseline to the specified time point. | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Number | 95% Confidence Interval | Percent of subjects w/ treatment success | 5 Years |
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| Secondary | Length of Time to Return to Pre-treatment Level of Physical Activity (in Days), Excluding Sexual Activity. | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | days | Up to five years |
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| Other Pre-specified | Length of Hospital Stay (LOS) | Defined as the time from admission to the healthcare facility until discharge (in hours). | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | hours | Peri-Operative Period |
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| Other Pre-specified | Length of Catheterization (LOC) | Defined as the time the subject required an indwelling Foley catheter post treatment (in hours). | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | hours | Recovery Period |
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| Other Pre-specified | Length of Procedure (LOP) | Defined as the time from cystoscope insertion into the urethra to the time of cystoscope removal (in minutes). | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | minutes | Procedure |
|
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| Other Pre-specified | Length of Lasing (LOL) | Total time the laser was on during the study procedure. | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | minutes | Procedure |
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| Other Pre-specified | Number of Fibers Used During Procedure | Participants who received the study treatment and for whom the outcome is available. | Posted | Mean | Standard Deviation | number of fibers used | Procedure |
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| Other Pre-specified | Total Joules Used | Total energy applied during the study procedure | Participants who received the study treatment and for whom the outcome measure is available. | Posted | Mean | Standard Deviation | kilojoules (kJ) | Procedure |
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| Secondary | Occurrence of Retrograde Ejaculation | Kaplan-Meier estimate of percentage of participants who experience retrograde ejaculation. | Participants who received the study treatment | Posted | Number | 95% Confidence Interval | percentage of subjects with RE | 5 Year Follow Up |
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Through study completion; planned to be 5 years.
All participants who received the study treatment will be considered at risk of having an adverse event. This study allowed adverse events to be collected not using specific event terms (e.g., "Other" adverse events).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | GreenLight HPS Laser System | GreenLight HPS Laser System therapy for patients with BPH. | 35 | 136 | 97 | 136 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Allergic Reaction / Hypersensitivity | General disorders | Systematic Assessment |
| ||
| Infection (other than UTI) | Infections and infestations |
| |||
| Perforation - Prostate | Renal and urinary disorders |
| |||
| Injury - Other | General disorders |
| |||
| Pain / Discomfort - Leg | Musculoskeletal and connective tissue disorders |
| |||
| Pain / Discomfort - Other | General disorders |
| |||
| Bladder Neck Contracture / Outlet Obstruct | Renal and urinary disorders |
| |||
| Hematuria - Gross | Renal and urinary disorders |
| |||
| Urinary Retention | Renal and urinary disorders |
| |||
| Deep Venous Thrombosis | Vascular disorders |
| |||
| Other: Death | General disorders |
| |||
| Other: Prostate Cancer | Renal and urinary disorders |
| |||
| Other: Renal Failure - Acute | Renal and urinary disorders |
| |||
| Other: Atrial Arrhythmia | Cardiac disorders |
| |||
| Other: Hernia | Musculoskeletal and connective tissue disorders |
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| Other: Lymphoma | Blood and lymphatic system disorders |
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| Other: Cardiomyopathy | Cardiac disorders |
| |||
| Other: Coronary Artery Disease | Vascular disorders |
| |||
| Other: Multiple Myeloma | Musculoskeletal and connective tissue disorders |
| |||
| Other: Rotator Cuff Tear | Musculoskeletal and connective tissue disorders |
| |||
| Other: Sleep Apnea | Respiratory, thoracic and mediastinal disorders |
| |||
| Other: Epistaxis | Blood and lymphatic system disorders |
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| Other: Stroke | Vascular disorders |
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| Other: Knee Replacement | Musculoskeletal and connective tissue disorders |
| |||
| Other: Obesity - Worsening | Metabolism and nutrition disorders |
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| Other | General disorders |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dysuria | Renal and urinary disorders |
| |||
| Retrograde Ejaculation - De Novo | Renal and urinary disorders |
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| Urinary Urgency | Renal and urinary disorders |
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| Retrograde Ejaculation | Renal and urinary disorders |
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| Urinary Frequency | Renal and urinary disorders |
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| Urinary Tract Infection (UTI) | Renal and urinary disorders |
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| Hematuria | Renal and urinary disorders |
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| Hematuria - Gross | Renal and urinary disorders |
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| Erectile Dysfunction - De Novo | Renal and urinary disorders |
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| Urinary Incontinence - De Novo | Renal and urinary disorders |
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| Pain / Discomfort - Other | General disorders |
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| Allergic Reaction / Hypersensitivity Reaction | General disorders |
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| Bladder Neck Contracture / Outlet Obstruct | Renal and urinary disorders |
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| Prostatitis | Renal and urinary disorders |
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| Urinary Retention - Acute | Renal and urinary disorders |
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| Nausea | Gastrointestinal disorders |
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| Urinary Retention | Renal and urinary disorders |
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| Erectile Dysfunction - Worsening | Renal and urinary disorders |
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| Perforation - Prostate | Renal and urinary disorders |
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| Sloughing | Renal and urinary disorders |
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| Urethral Stricture | Renal and urinary disorders |
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| Vomiting | Gastrointestinal disorders |
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| Other: Nocturia | Renal and urinary disorders |
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| Other: Urinary Dribbling | Renal and urinary disorders |
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| Other: Hypertension | Cardiac disorders |
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| Other: Bladder Spasm | Renal and urinary disorders |
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| Other: Lack of Sensation During Ejaculation | Renal and urinary disorders |
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| Other: Overactive Bladder | Renal and urinary disorders |
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| Other: Paraphimosis | Skin and subcutaneous tissue disorders |
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| Other: Urethral Burning at Foley Catheter Site | Renal and urinary disorders |
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| Other: Urine Flow Decreased Force | Renal and urinary disorders |
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| Other: Bladder Pressure | Renal and urinary disorders |
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| Other: Clot Retention | Renal and urinary disorders |
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| Other: Decrease Sense of Emptying Bladder | Renal and urinary disorders |
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| Other: Sexual Dysfunction | Reproductive system and breast disorders |
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| Other | General disorders |
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Follow-up of subjects was discontinued in August 2012 prior to most participants completing the assessment planned at 5 years. At the time of the discontinuation, all but five of the participants remaining on study had completed 3 years of follow-up.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Mara M. LaRock, Senior Manager, Clinical Franchise Lead | American Medical Systems | 952-930-6000 | mara.larock@bsci.com |
| ID | Term |
|---|---|
| D011470 | Prostatic Hyperplasia |
| D059411 | Lower Urinary Tract Symptoms |
| ID | Term |
|---|---|
| D011469 | Prostatic Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Unknown or Not Reported |
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| OG007 | 5 Years |
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| OG007 | 5 Years |
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