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difficulty in the enrolment
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The study is designed to demonstrate that treatment with low level stimulation of the bladder muscles reduces symptoms of urinary incontinence in comparison with no stimulation.
The Medtronic InterStim device delivers stimulation therapy for the treatment of chronic intractable (functional) disorders of the pelvis and lower urinary or intestinal tract through the sacral nerve or the pudendal nerve systems.
This trial is designed to demonstrate that neuromodulation of the pudendal nerve will effectively treat patients with neurogenic overactive bladder. Symptoms of urinary incontinence are compared when stimulation is switched on for 4 weeks to stimulation switched off for 4 weeks. After the eight week crossover period, all patients receive treatment and are followed up within the study for 12 months post implant.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ON / OFF | Other | Stimulation ON for 4 weeks, followed by stimulation OFF for 4 weeks. |
|
| OFF / ON | Other | Stimulation OFF for 4 weeks, followed by stimulation ON for 4 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| InterStim Therapy | Device | Neuromodulation therapy which delivers low level electrical stimulation to bladder wall for the treatment of overactive bladder with urinary incontinence. |
| Measure | Description | Time Frame |
|---|---|---|
| Functional Bladder Capacity | Functional Bladder capacity is measured as the average passed volume per episode, in milliliters, as recorded in the patient's voiding diary during the observation period. Due to the small number of patients in each group, the summary on the functional bladder capacity was provided for the combined groups. | Baseline, 4 weeks after implant, 8 weeks after implant |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michele Spinelli, MD | Ospedale Niguarda Ca' Granda, Milan, Italy | Principal Investigator |
| Karel Everaert, MD | University Ghent | Principal Investigator |
| Philip Van Kerrebroeck, MD | Academisch Ziekenhuis, Maastricht, The Netherlands | Principal Investigator |
| Emmanuel Chartier-Kastler, MD | Hôpital de la Pitié Salpétrière, Paris, France | Principal Investigator |
| Arndt Van Ophoven, MD | Marienhospital Herne Klinikum der Ruhr-Universität, Herne, Germany | Principal Investigator |
| Karl Sievert, MD | Klinik für Urologie Oberarzt-Sekretariat, Tübingen, Germany | Principal Investigator |
| Suzy Elneil, MD | National Hospital for Neurology and Neurosurgery, London, UK | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitair Ziekenhuis Gent | Ghent | Belgium | ||||
| Centre Hospitalier Universitaire de Lyon-Sud |
17 patients were included in the study: 9 patients did not pass the test stimulation period, 1 patient dropped out due to exclusion criteria, 1 patient dropped out due to protocol deviation during screening visit, 1 patient dropped out before test stimulation due to early termination of the study, leaving 5 patients who were randomized.
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| ID | Title | Description |
|---|---|---|
| FG000 | ON / OFF | Stimulation ON for 4 weeks, followed by stimulation OFF for 4 weeks. InterStim Therapy: Neuromodulation therapy which delivers low level electrical stimulation to bladder wall for the treatment of overactive bladder with urinary incontinence. |
| FG001 | OFF / ON | Stimulation OFF for 4 weeks, followed by stimulation ON for 4 weeks. InterStim Therapy: Neuromodulation therapy which delivers low level electrical stimulation to bladder wall for the treatment of overactive bladder with urinary incontinence. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
The analysis was based on all randomized patients in the study. Due to early termination of the study, only 17 patients have been enrolled versus 78 planned enrolled patients. No analysis was done comparing the functional bladder capacity between the two intervention groups due to the low patient numbers in each group.
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| ID | Title | Description |
|---|---|---|
| BG000 | Total Patient | The patient demographic were analysed without splitting by study intervention since all randomized subjects were to receive both stimulation options (ie, ON and OFF)." |
| 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 | Functional Bladder Capacity | Functional Bladder capacity is measured as the average passed volume per episode, in milliliters, as recorded in the patient's voiding diary during the observation period. Due to the small number of patients in each group, the summary on the functional bladder capacity was provided for the combined groups. | Due the small number of patients in each group, the summary on the functional bladder capacity was provided for the combined groups. | Posted | Mean | Standard Deviation | ml | Baseline, 4 weeks after implant, 8 weeks after implant |
|
Adverse event reporting started at enrollment until study completion and/or study exit, an average of 14 months, whatever applies.
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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 | All Enrolled Patients | Adverse events in this study were reported on the 17 enrolled patients. Due to the small number of patients in each group, the summary on adverse events was provided for the combined groups. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Infection of the device stimulator | Infections and infestations | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| URINARY INFECTION | Infections and infestations | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Alexandra Delacour, Clinical Research Manager | Medtronic International Trading Sarl | 0041218027622 | alexandra.delacour@medtronic.com |
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| ID | Term |
|---|---|
| D014549 | Urinary Incontinence |
| D053201 | Urinary Bladder, Overactive |
| ID | Term |
|---|---|
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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| Lyon |
| France |
| Hôpital de la Pitié Salpétrière | Paris | France |
| Marienhospital Herne, Klinikum der Ruhr-Universitaet Bochum | Herne | 44627 | Germany |
| Klinik für Urologie Oberarzt-Sekretaria | Tübingen | Germany |
| Niguarda Ospedale Ca' Granda | Milan | 20162 | Italy |
| Academisch Ziekenhuis | Maastricht | Netherlands |
| National Hospital for Neurology and Neurosurgery | London | United Kingdom |
| year |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
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| 0 |
| 17 |
| 1 |
| 17 |
| 7 |
| 17 |
| pain after surgery | Surgical and medical procedures | Systematic Assessment |
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| Bronchitis | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Battery empty at 07h30 and return of symptoms | Investigations | Systematic Assessment |
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| Lead cut by the nurse | Investigations | Systematic Assessment |
|
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| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001745 | Urinary Bladder Diseases |