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| ID | Type | Description | Link |
|---|---|---|---|
| G090011 |
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Surgery is the main treatment for localized prostate cancer. The most common technique is a "radical prostatectomy," which involves removing the prostate gland, seminal vesicles and nearby lymph nodes. Radical prostatectomy is a major operation, most suitable for otherwise healthy men whose cancer does not appear to have spread.One of the most technically challenging aspects of this surgery is reconstruction of the interrupted urinary tract by hand suturing the bladder neck anastomosis, in which the bladder neck is sewn to the urethra after the prostate has been removed.
CONTINUUMâ„¢ (study Device) is a surgical device intended to be used as part of the radical prostatectomy procedure. The Device facilitates approximation of the bladder neck and urethral stump by bringing together and holding the tissue in place until adequate natural healing of the vesico-urethral anastomosis occurs. CONTINUUMâ„¢ also approximates the bladder and urethral stump to minimize extravasation, while simultaneously providing a conduit for drainage of urine from the bladder while the anastomotic site heals.
The concept of the CONTINUUMâ„¢ device and the feasibility of its operation have been tested in animal and human studies. Pilot clinical studies in the United States (G060095) found that the majority of Subjects who received and were discharged with the Device demonstrated a water-tight vesico-urethral anastomosis at the first Device removal visit. Additionally, no unanticipated adverse device effects (UADEs) were reported. The intent of this study is to verify CONTINUUMâ„¢ device performance across a variety of US sites and physicians using updated CONTINUUMâ„¢ device design modifications and physician training methodology on Device implant and removal techniques prior to initiation of a randomized US Pivotal study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Continuum | Experimental | Verify the consistency of performance of the AMS CONTINUUM device in facilitating a sustainable anastomosis following a radical prostatectomy using updated Device design elements and Physician training materials on Device implant technique. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CONTINUUMâ„¢ | Device | Performance of CONTINUUMâ„¢ in facilitating the vesico-urethral anastomosis following radical prostatectomy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety - Infection That Requires IV Antibiotics or Re-hospitalization | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Successful Device Placement | Defined as the establishment of a water-tight anastomosis immediately post-Device placement. | At Device placement |
| Functionally Adequate Vesico-urethral Anastomosis Within 21 Days Post-Device Placement in Subjects With Successful Device Placement | Evaluated by the proportion of Subjects who have had a successful Device placement and developed a functionally adequate anastomosis within 21 days post procedure (i.e. minimal or no extravasation noted during post-placement) | 7-21 days post-Device placement |
| Safety - Perforation of the Bowel or Bladder | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Safety - Creation of a False Passage | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Safety - Urinary Retention Requiring Catheterization Post-Device Removal |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative/Postoperative Parameters - Estimated Blood Loss | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as blood loss. | At Device placement |
| Extravasation During Post-placement Cystogram at Either the First or Second Device Removal Attempts |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Naveen Kella, MD | Urology San Antonio Research PA | Principal Investigator |
| John Libertino, MD | Lahey Clinic Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Arkansas Urology | Little Rock | Arkansas | 72211 | United States | ||
| Lahey Clinic Medical Center |
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| ID | Title | Description |
|---|---|---|
| FG000 | Continuum | Verify the consistency of performance of the AMS CONTINUUM device in facilitating a sustainable anastomosis following a radical prostatectomy using updated Device design elements and Physician training materials on Device implant technique. CONTINUUMâ„¢: Performance of CONTINUUMâ„¢ in facilitating the vesico-urethral anastomosis following radical prostatectomy. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Male patients ≥ 40 years old indicated for radical prostatectomy
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| ID | Title | Description |
|---|---|---|
| BG000 | Continuum Device | Performance evaluation of the AMS Continuum device in facilitating vesico-urethral anastomosis following a radical prostatectomy |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Safety - Infection That Requires IV Antibiotics or Re-hospitalization | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
Adverse events were collected that occurred during placement, wearing of the CONTINUUM device and during the 6-month follow-up
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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 | Continuum Device | Performance evaluation of the AMS Continuum device in facilitating vesico-urethral anastomosis following a radical prostatectomy |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Excessive bleeding | Surgical and medical procedures |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Urinary Incontinence - De Novo | Renal and urinary disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Laura Olson, Clinical Project Manager | American Medical Systems | 952-930-6428 | laura.olson2@bsci.com |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D003266 | Continuity of Patient Care |
| ID | Term |
|---|---|
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. |
| At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Safety - Mechanical Failure, Extrusion, Erosion, or Migration of the Device Requiring Surgical or Medical Intervention | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Safety - Separation/Disruption of the Anastomosis Requiring Corrective Intervention | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| Safety - Bladder Neck Contracture | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
| 7-10 and 13 - 15 days post-Device placement |
| Intraoperative/Postoperative Parameters - Total Device Placement Time | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as length of Device placement. | At Device placement |
| Intraoperative/Postoperative Parameters - Total Radical Prostatectomy Operative Time | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as length of RP procedure. | At Device placement |
| Burlington |
| Massachusetts |
| 01805 |
| United States |
| Center for Urology | Rochester | New York | 14619 | United States |
| Urologic Consultants of Southeastern Pennsylvania | Philadelphia | Pennsylvania | 19004 | United States |
| Urology Clinics of North Texas | Dallas | Texas | 75231 | United States |
| Urology San Antonio Research PA | San Antonio | Texas | 78205 | United States |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Body Mass Index | Mean | Standard Deviation | kg/m2 |
|
| History of smoking | Count of Participants | Participants |
|
| Prostate size (g) via TRUS | Mean | Standard Deviation | grams |
|
| Participants |
|
|
| Primary | Successful Device Placement | Defined as the establishment of a water-tight anastomosis immediately post-Device placement. | Subjects in whom device placement was attempted (i.e. treated subjects) | Posted | Count of Participants | Participants | At Device placement |
|
|
|
| Primary | Functionally Adequate Vesico-urethral Anastomosis Within 21 Days Post-Device Placement in Subjects With Successful Device Placement | Evaluated by the proportion of Subjects who have had a successful Device placement and developed a functionally adequate anastomosis within 21 days post procedure (i.e. minimal or no extravasation noted during post-placement) | Posted | Count of Participants | Participants | 7-21 days post-Device placement |
|
|
|
| Secondary | Intraoperative/Postoperative Parameters - Estimated Blood Loss | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as blood loss. | Subjects in whom device placement was attempted | Posted | Mean | Standard Deviation | cc | At Device placement |
|
|
|
| Secondary | Extravasation During Post-placement Cystogram at Either the First or Second Device Removal Attempts | Subjects with successful device placement | Posted | Count of Participants | Participants | 7-10 and 13 - 15 days post-Device placement |
|
|
|
| Secondary | Intraoperative/Postoperative Parameters - Total Device Placement Time | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as length of Device placement. | Subjects in whom device placement was attempted | Posted | Mean | Standard Deviation | Minutes | At Device placement |
|
|
|
| Secondary | Intraoperative/Postoperative Parameters - Total Radical Prostatectomy Operative Time | To assess short-term clinical outcomes of the Device in facilitating the vesico-urethral anastomosis following a radical prostatectomy such as length of RP procedure. | Subjects in whom device placement was attempted | Posted | Mean | Standard Deviation | Minutes | At Device placement |
|
|
|
| Primary | Safety - Perforation of the Bowel or Bladder | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| Primary | Safety - Creation of a False Passage | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| Primary | Safety - Urinary Retention Requiring Catheterization Post-Device Removal | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| Primary | Safety - Mechanical Failure, Extrusion, Erosion, or Migration of the Device Requiring Surgical or Medical Intervention | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| Primary | Safety - Separation/Disruption of the Anastomosis Requiring Corrective Intervention | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| Primary | Safety - Bladder Neck Contracture | Safety of the device was evaluated by incidences of specific serious Device-related adverse complications that occurred during placement, wearing of the CONTINUUM device and during 6-month follow-up. | Subjects in whom device placement was attempted | Posted | Number | Events | At Device placement, Device removal, 4 weeks post-Device removal, 6 months post-Device removal |
|
|
|
| 3 |
| 31 |
| 30 |
| 31 |
| Bladder Neck Contracture/Outlet Obstruct | Renal and urinary disorders |
|
| Separation/Disruption of Anastomosis | Renal and urinary disorders |
|
| Syncope | Cardiac disorders |
|
| Pain/Discomfort | General disorders |
|
| Pain/Discomfort - Other | General disorders |
|
| Hematuria | Renal and urinary disorders |
|
| Erectile Dysfunction - De Novo | Reproductive system and breast disorders |
|
| Pain/Discomfort - Abdominal | Gastrointestinal disorders |
|
| Erectile Dysfunction - Worsening | Reproductive system and breast disorders |
|
| Infection | Infections and infestations |
|
| Urinary Tract Infection (UTI) | Infections and infestations |
|
| Urinary Retention | Renal and urinary disorders |
|
| Dysuria | Renal and urinary disorders |
|
| False Passage | Renal and urinary disorders |
|
| Perforation - Bladder | Renal and urinary disorders |
|
| Nausea | Gastrointestinal disorders |
|
| Pain/Discomfort - Back | Musculoskeletal and connective tissue disorders |
|
| Nocturia | Renal and urinary disorders |
|
| Dizziness | General disorders |
|
| Abdominal Bloating/Gas | Gastrointestinal disorders |
|
| Constipation | Gastrointestinal disorders |
|
| Fluid Overload (Hypervolemia) | Vascular disorders |
|
| Loss of appetite | Gastrointestinal disorders |
|
| Actelectasis | Respiratory, thoracic and mediastinal disorders |
|
| Bladder Spasm | Renal and urinary disorders |
|
| Clot in catheter | Renal and urinary disorders |
|
| Disease progession | Renal and urinary disorders |
|
| Hemorrhoid | General disorders |
|
| Increased Creatinine | Renal and urinary disorders |
|
| Inguinal Hernia | Musculoskeletal and connective tissue disorders |
|
| Kidney Stone | Renal and urinary disorders |
|
| Light Headed | General disorders |
|
| Tunnel Vision | Eye disorders |
|
| Vasovagal Reaction | Cardiac disorders |
|
| Bladder Neck Contracture/Outlet Obstruct | Renal and urinary disorders |
|
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| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D011320 | Primary Health Care |
| D003191 | Comprehensive Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |
|
| Disrupted anastomosis requiring surgical intervent |
|