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The purpose of this study is to develop a recommended local anesthetic protocol and post-treatment pain management regimen, in order to assure patient comfort during office-based treatment with the MyoSure Hysteroscopic Tissue Removal Device. Subject self-reported pain scores (as rated on an 11 point scale) will be compared at multiple time intervals between all treatment groups.
Forty subjects will be enrolled in a randomized, controlled study conducted at four physician offices or day surgery settings. Subjects will be randomized 1:1 to a local anesthetic group (Group #1 or Group #2). Subjects will undergo a hysteroscopic tissue removal procedure to remove intrauterine polyps, type 0 fibroids, or type I fibroids. Subsequent to the procedure, subjects will be randomized 1:1 within the local anesthetic group to a post procedure pain management group (Group A or Group B). Subject self-reported pain scores (as rated on an 11 point scale)will be compared at three time points: Immediately post procedure, prior to discharge from the treatment facility, and at 48 hours post procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cervical Block, 6 injection sites | Experimental | Subject will receive a cervical block of 1% lidocaine and 0.25% bupivacaine, with injections in the following locations: 2cc at 12:00, 10cc at 3:00, 10 cc at 9:00, 5 cc at 4:00, 5 cc at 8:00, and 5 cc at 6:00. |
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| Cervical Block, 2 injection sites | Experimental | Subject will receive a cervical block of 1% lidocaine and 0.25% bupivacaine, with injections in the following locations: 10 cc at 4:00, and 10 cc at 8:00. |
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| Ibuprofen q. 8 hours | Experimental | Subjects will receive a post procedure pain management regimen of ibuprofen 800 mg every 8 hours, for the first 24 hours and then PRN. |
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| Ibuprofen PRN | Experimental | Subjects will receive a post procedure pain management regimen of ibuprofen 800 mg PRN. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hysteroscopic Morcellator | Device | The MyoSure Tissue Removal Device consists of a hand-held tissue removal device comprising a mechanical drive assembly connected to a drive cable and associated control box on one end, and a 3 mm shaft on the other end of the device. The shaft is approximately 12 cm long and equipped with an open channel that houses an oscillating blade.When the side channel is exposed to target tissue and the motor is activated, the oscillating blade will cut the tissue within the channel. Once cut, the tissue travels down the center of the 3mm shaft via suction coupled to the proximal end of the tissue removal device, and is trapped in a vacutainer bottle. |
| Measure | Description | Time Frame |
|---|---|---|
| Subject tolerance of procedure-related pain rated on an 11 point scale (0-10) | Immediately post treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Subject assessment of most severe post-procedural pain rated on an 11 point scale | Prior to subject discharge from office/day surgery unit | |
| Subject assessment of most severe pain experienced during 48 hours post procedure, rated on an 11 point scale | 48 hours (+ 24 hours) post procedure |
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Inclusion Criteria:
Healthy female between the ages of 18 and 65
Subject must be able to understand, read and sign the study specific informed consent forms after the nature of the study has been fully explained to her
Subject is a pre-menopausal or peri-menopausal female, either nulliparous or parous
Subject is indicated for myomectomy or polypectomy for benign pathology, based on hysteroscopic, ultrasound, or saline infused sonogram assessment within 60 days
Subject exhibits intrauterine polyps and/or submucous myomas which meet one of the following criteria. In cases of subjects with multiple intrauterine pathology, classification is based as follows:
Negative pregnancy test within 48 hours prior to planned index procedure and willing to use reliable birth control for the next 30 days. Reliable birth control is defined as a chemical or barrier method, including an oral contraceptive, injectable contraceptive, or the combination of a spermicide and condoms
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Andrea Lukes, MD | Carolina Women's Research and Wellness Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Phoenix Gynecology Consultants | Phoenix | Arizona | 85013 | United States | ||
| Florida Woman Care |
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| ID | Term |
|---|---|
| D007889 | Leiomyoma |
| D011127 | Polyps |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D009379 | Neoplasms, Muscle Tissue |
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| Boca Raton |
| Florida |
| 33431 |
| United States |
| Wayne State University | Detroit | Michigan | 48201 | United States |
| Minnesota Gynecology and Surgery | Edina | Minnesota | 55435 | United States |
| Carolina Women's Research and Wellness Center | Durham | North Carolina | 27713 | United States |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |