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This is a clinical study without a formal hypothesis. The primary objective of the study is to evaluate the use of the Aurora Endometrial Ablation System in achieving a return to normal menstrual blood loss at 12 months post-treatment, in premenopausal women with menorrhagia due to benign causes for whom childbearing is complete or no longer wish to retain fertility.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aurora Treatment Arm | Experimental | Endometrial Ablation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aurora Endometrial Ablation System | Device | Ablation of the endometrial lining of the uterus using the Aurora System |
|
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in Menstrual Blood Loss to Normal Levels at 12 Months | Number of subjects in whom menstrual blood loss was reduced to normal or below normal levels at 12 months, as measured by a pictorial blood loss assessment chart (PBLAC) score of <=75. | 12 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Procedure Time | Procedure time defined as time from insertion of the Disposable Handpiece to the time of removal | < 1 hour |
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Inclusion Criteria:
Refractory menorrhagia with no definable organic cause
Female subject from age 25 to 50 years
Uterine sound measurement of 6.0cm to 10.0cm (external os to internal fundus)
One of the following criteria:
A. Documented history of menorrhagia secondary to dysfunctional uterine bleeding (DUB).
B. If a pictorial blood loss assessment chart (PBLAC) scoring systems is used; a minimum PBLAC score of ≥150 for 3 months prior to study enrollment; OR, A minimum PBLAC score ≥150 for one month for women who either i. had at least 3 prior months documented failed medical therapy; or ii. had a contraindication to medical therapy; or iii. refused medical therapy
Premenopausal at enrollment as determined by FSH measurement ≤ 40 IU/ml
Not pregnant and no desire to be pregnant in the future
Patient agrees not to use hormonal contraception or any other medical intervention for bleeding during the study
Able to provide written informed consent using a form that has been approved by the reviewing IRB/EC
Subject agrees to follow-up exams and data collection, including ability to accurately use menstrual diaries
Subject who is literate or demonstrates an understanding on how to use menstrual diaries or how to collect and provide used sanitary products
Exclusion Criteria:
Pregnancy or subject with a desire to conceive
Endometrial hyperplasia as confirmed by histology
Presence of active endometritis
Active pelvic inflammatory disease
Active sexually transmitted disease (STD), at the time of ablation. Note: Treatment of STD documented in the chart serves as sufficient evidence of infection resolution. Patient may be considered for study enrollment.
Presence of bacteremia, sepsis, or other active systemic infection
Active infection of the genitals, vagina, cervix, uterus or urinary tract at the time of the procedure
Known/suspected gynecological malignancy within the past 5 years
Known clotting defects or bleeding disorders
Untreated/unevaluated cervical dysplasia (except CIN I)
Known/suspected abdominal/pelvic cancer
Prior uterine surgery (except low segment cesarean section) that interrupts the integrity of the uterine wall (e.g., myomectomy or classical cesarean section)
Previous endometrial ablation procedure
Currently on medications that could thin the myometrial muscle, such as long-term steroid use (except inhaler or nasal therapy for asthma)
Currently on anticoagulants
Abnormal or obstructed cavity as confirmed by hysteroscopy or SIS, specifically:
Presence of an intrauterine device (IUD) which the patient is unwilling to have removed at the time of the operative visit
Presence of an implantable contraceptive device (e.g. Essure or Adiana).
Subject currently on hormonal birth control therapy or unwilling to use a non-hormonal birth control post-ablation (including a Mirena device).
Subject who is within 6-weeks post partum.
Any general health condition which, in the opinion of the Investigator, could represent an increased risk for the subject
Any subject who is currently participating or considers future participation in any other research of an investigational drug or device.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitario, UANL | Monterrey | Nuevo León | 64460 | Mexico |
24 subjects enrolled: all subjects met the study criteria including hysteroscopic screening prior to the procedure. All 24 subjects completed the treatment. The protocol ITT (Intent-To-Treat) population included all subjects in whom treatment was attempted (i.e., all subjects in whom the experimental device was attempted to be placed).
Subjects were enrolled in the clinical trial at 1 Investigational Site in Mexico. All subjects were enrolled during September 2011.
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| ID | Title | Description |
|---|---|---|
| FG000 | Aurora Treatment Arm | Endometrial Ablation Aurora Endometrial Ablation System: Ablation of the endometrial lining of the uterus using the Aurora System |
| Title | Milestones | Reasons Not Completed | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Enrolled subjects
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| ID | Title | Description |
|---|---|---|
| BG000 | Aurora Treatment Arm | Endometrial Ablation Aurora Endometrial Ablation System: Ablation of the endometrial lining of the uterus using the Aurora System |
| 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 | Reduction in Menstrual Blood Loss to Normal Levels at 12 Months | Number of subjects in whom menstrual blood loss was reduced to normal or below normal levels at 12 months, as measured by a pictorial blood loss assessment chart (PBLAC) score of <=75. | Protocol Intent-to-treat population (all subjects in whom the experimental device was attempted to be placed.) | Posted | Number | participants | 12 Months |
|
|
1 year
All Adverse Events observed during the clinical study, regardless of relationship to the study device or procedure are reported below.
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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 | Aurora Treatment Arm | Endometrial Ablation Aurora Endometrial Ablation System: Ablation of the endometrial lining of the uterus using the Aurora System |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anesthesia Related | Surgical and medical procedures | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Eugene Skalnyi, VP Medical Affairs | Minerva Surgical, Inc. | (1) 650-284-3500 | eugenes@minervasurgical.com |
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| ID | Term |
|---|---|
| D008595 | Menorrhagia |
| D008796 | Metrorrhagia |
| ID | Term |
|---|---|
| D014592 | Uterine Hemorrhage |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
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| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| PBLAC Score (assessment of menstrual blood loss) | Pictorial Blood Loss Assessment Chart (PBLAC) is a tool used to assess menstrual blood loss. The PBLAC score takes into account the number of menstrual pads and tampons used as well as amount of saturation. A score of 0 represents no bleeding. Although the PBLAC score does not yield an exact measure of blood loss, it has been found to correlate well with menstrual blood volume. A score greater than 100 is correlated with a blood loss of at least 80 mL. | Mean | Standard Deviation | units on a scale |
|
| Participants |
|
|
| Secondary | Procedure Time | Procedure time defined as time from insertion of the Disposable Handpiece to the time of removal | Subjects completing treatment | Posted | Mean | Standard Deviation | Minutes | < 1 hour |
|
|
|
| Post-Hoc | Subjects With Amenorrhea at 12 Months | Amenorrhea at 12 Months- Number of Subjects experiencing no menstrual bleeding | Protocol Intent-to-treat | Posted | Number | participants | 12 months |
|
|
|
| 0 |
| 24 |
| 21 |
| 24 |
| Endometritis | Reproductive system and breast disorders | Systematic Assessment |
|
| Pelvic Cramping (non-specific) | Reproductive system and breast disorders | Systematic Assessment |
|
| Pelvic Cramping (dyspareunia) | Reproductive system and breast disorders | Systematic Assessment |
|
| Vaginal Discharge | Reproductive system and breast disorders | Systematic Assessment |
|
| Urinary Tract Infection | Infections and infestations | Systematic Assessment |
|
| Pelvic Inflammatory Disease (PID) | Reproductive system and breast disorders | Systematic Assessment |
|
| Abdominal Bloating | Gastrointestinal disorders | Systematic Assessment |
|
| Anxiety/Mood Swings | Psychiatric disorders | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | Systematic Assessment |
|
| Flu | General disorders | Systematic Assessment |
|
| Sensation of Weight Gain | General disorders | Systematic Assessment |
|
| Fatigue | General disorders | Systematic Assessment |
|
| Hands and Feet Swelling | General disorders | Systematic Assessment |
|
| Headache | Nervous system disorders | Systematic Assessment |
|
| Spotting | Reproductive system and breast disorders | Systematic Assessment |
|
| Paresthesia of the Vulva | Reproductive system and breast disorders | Systematic Assessment |
|
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| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008599 | Menstruation Disturbances |