Medication Effects on Periurethral Sensation,Urethral Sphincter Activity and Pressure Flow Parameters
Medication Effects on Periurethral Sensation, Urethral Sphincter Activity and Pressure Flow Parameters
Lower urinary tract symptoms such as urinary leakage and overactive bladder affect millions of American women. Women may develop these problems because the innervation of the muscles of the bladder and urethra are injured. Most research on treating these problems has focused on the abnormalities of the bladder muscle, but newer studies have shown abnormalities in the innervation and muscle function of the urethra.
Women with these symptoms may benefit from treatment with medications to improve their urethral function. However, to truly understand what types of medications will help women with these symptoms, the investigators wish to study how these medications affect innervation and muscle function in healthy women who do not have lower urinary tract symptoms.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Alabama
-
Birmingham, Alabama, United States, 35233
- University of Alabama at Birmingham, The Kirklin Clinic
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Healthy Females only
- Ages 19-51 and up including pre-menopausal older women who have had a normal menstrual cycle for the prior 3 months
- Able to take oral medication for 2 weeks
- For women of child bearing potential,willing to use an approved method of birth control during the study
Exclusion Criteria:
- Urinary Incontinence or other bladder symptoms
- Known neurologic disease that may impair urethral tone or sensation
- Currently taking a class of medication that is being tested (alpha-antagonists, anticholinergics, sympathomimetics, tricyclic antidepressants, or skeletal muscle relaxants)
- History of QTc prolongation or cardiac arrhythmia
- Pregnant, breastfeeding, or are less than 6 months postpartum
- Known hypersensitivity to or other contraindications to taking any of the study medications
Study Plan
How is the study designed?
Design Details
- Primary Purpose: BASIC_SCIENCE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Pseudoephedrine
Pseudoephedrine 120mg extended release tablets
|
Pseudoephedrine ER 120 mg by mouth once daily for 2 weeks
|
|
ACTIVE_COMPARATOR: Solifenacin
Solifenacin 5mg capsule
|
Solifenacin 5mg by mouth daily for 2 weeks
Other Names:
|
|
ACTIVE_COMPARATOR: Tamsulosin
Tamsulosin 0.4mg capsule
|
Tamsulosin 0.4mg by mouth daily for 2 weeks
Other Names:
|
|
ACTIVE_COMPARATOR: Imipramine
Imipramine 25mg tablet
|
Imipramine 25mg daily by mouth for 2 weeks
Other Names:
|
|
ACTIVE_COMPARATOR: Cyclobenzaprine
Cyclobenzaprine 10mg tablet
|
Cyclobenzaprine 10mg daily by mouth for 2 weeks
Other Names:
|
|
PLACEBO_COMPARATOR: Lactose capsules
Sham
|
Lactose capsule 1 by mouth daily for 2 weeks
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Difference (Pre - Post) in Amplitude (Microvolts) of Urethral Sphincter Activity as Measured by Quantitative Concentric Needle EMG
Time Frame: 2 weeks
|
Concentric needle EMG was used to measure urethral sphincter activity at 2-3 sites around the urethral meatus before and after 2 weeks of therapy with one of 6 randomly assigned medications.
Two methods of quantitative electromyography were performed on all subjects.
(1) Multi-Motor Unit Action Potential (MUP) analysis, which has been shown to be the most sensitive technique in distinguishing neuropathic from control muscles; and (2) interference pattern analysis (IPA) which reflects changes in MUP recruitment from weak effort to maximal contraction.
|
2 weeks
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Difference (Pre - Post) in Urethral Sensation (Milliamps) as Measured by Current Perception Threshold Testing.
Time Frame: 2 weeks
|
Current Perception Threshold testing was used to measure urethral sensation before and after 2 weeks of therapy with one of 6 randomly assigned medications.
We performed CPT testing in the urethra using a Neurometer®, which is a constant current stimulator capable of delivering sine wave electrical stimuli at 3 frequencies (2000 Hz, 250 Hz and 5 Hz).
At all 3 frequencies, the stimulus intensity was gradually increased until first perceived, and then decreased until no longer perceptible.
CPT values were obtained using a semi-automated forced choice paradigm.
|
2 weeks
|
|
Difference (Pre - Post) in Maximum Urine Flow Rate (Qmax) (Milliliters Per Second) as Measured by Pressure Flowmetry
Time Frame: 2 weeks
|
Pressure Flowmetry was used to measure maximum urine flow rate (Qmax)before and after 2 weeks of therapy with one of 6 randomly assigned medications.
A 300 cc bladder fill was performed through the catheter, the catheter was removed, and transurethral and transrectal pressure transducers were placed for the pressure flow study.
Voiding was performed in the seated position.
Information obtained for the database included Qmax, average flow rate, time to Qmax, detrusor pressure at maximum flow rate, voided volume, and a calculated post-void residual.
|
2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Greer WJ; Gleason J; Szychowski JM; Goode P; Kenton K; Richter HE. Medication Effects on Urethral Current Perception Thresholds and Pressure Flow Parameters. Fem Pelv Med Recons Surg 2011;17:S33.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Adrenergic Antagonists
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Autonomic Agents
- Peripheral Nervous System Agents
- Muscarinic Antagonists
- Cholinergic Antagonists
- Cholinergic Agents
- Urological Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Antidepressive Agents
- Antidepressive Agents, Tricyclic
- Bronchodilator Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Neuromuscular Agents
- Central Nervous System Stimulants
- Sympathomimetics
- Adrenergic Uptake Inhibitors
- Adrenergic alpha-1 Receptor Antagonists
- Adrenergic alpha-Antagonists
- Vasoconstrictor Agents
- Muscle Relaxants, Central
- Nasal Decongestants
- Tamsulosin
- Ephedrine
- Pseudoephedrine
- Solifenacin Succinate
- Cyclobenzaprine
- Imipramine
Other Study ID Numbers
Other Study ID Numbers
- VESI-9E03-UAB
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