Study of Endorectal Cooling During RARP to Minimize Trauma and Promote Earlier Return to Continence (UroCool)
A Randomized, Controlled Study of the Use of Localized Endorectal Cooling Using the UroCool System During Robotic-Assisted Radical Prostatectomy (RARP) to Minimize Trauma and to Provide Earlier Return to Continence
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This study will assess the use of an endorectal cooling device, UroCool, to achieve controlled, local hypothermia of the pelvis. The study will evaluate the safety and effectiveness of the device in inducing hypothermia of the neuromuscular tissues impacting continence during RARP.
The UroCool system is designed to apply targeted temperature control to the pelvic anatomy during RARP. The pelvis is cooled transrectally via a closed cycle recirculation of chilled sterile saline using a single-use disposable balloon catheter connected via a circulation IV set to a control console that is covered by a current 510(k) and commercially available.
The UroCool polymeric catheter is designed to be inserted within the rectal cavity adjacent to the prostate prior to surgery and removed upon completion of surgery. It is used in conjunction with the InnerCool Console which circulates cold saline in a closed loop within the UroCool catheter to allow for therapeutic localized cooling of the prostate gland and surrounding areas during prostate surgery.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Gronau, Germany, 48599
- St. Antonius-Hospital Gronau GmbH
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-
-
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California
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Duarte, California, United States, 91010
- City of Hope
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Washington
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Seattle, Washington, United States, 98122
- Swedish Medical Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patient is male and a candidate for robotic assisted radical prostatectomy (RARP) for the treatment of prostate cancer
- Patient is over eighteen (>18) years of age
- Patient reads, understands and speaks English fluently (U.S. Sites only)
- Subject understands and agrees to all pre-operative preparation procedures including a "self-administered" fleet enema
- Subject understands study procedures, risks of such procedures and is willing to comply with all study procedures
- Patient is willing and able to comply with all post-surgical milestones including completing and returning post-surgery follow up questionnaires at specified intervals over a 12 month period
- Subject agrees to participate in the study and is willing to sign the written informed consent per the enrolling site's institutional procedure
Exclusion Criteria:
- Presents with baseline or has a history of urinary incontinence
- Rectal or GI pathology deemed unsuitable for placement of the treatment device by the examining physician
- Prior extensive pelvic surgery such as low anterior resection, abdominoperineal resection, or proctocolectomy continent stool pouch, or any other extensive abdominopelvic surgery that would render the patient a high-risk for complications as deemed by the surgeon
- History of prior treatment of any kind for prostate cancer; e.g. radiation therapy, cryotherapy, high-intensity focused ultrasound (HIFU), hormonal or chemotherapy
- Prior intra-operative injuries (for example: rectal injury)
- Inadequate hemostasis
- Serious concurrent medical condition likely to result in death during the next 12 months. Any other acute or chronic condition which the Investigator believes will unacceptably increase the risk of study participation or interfere with study procedures and assessments.
- Active or recent (within 1 month prior to study enrollment) participation in another investigational clinical research study or planned to be enrolled in another study of prostate therapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Local cooling/hypothermia
These patients will have the UroCool device inserted prior to RARP to induce localized cooling/hypothermia of the pelvic region prior to and during RARP surgery.
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These patients will receive the UroCool device which will be inserted just prior to RARP surgery.
The UroCool device will be used to effect localized cooling/hypothermia of the pelvic region prior to and during RARP surgery.
It will be removed at the end of surgery.
Other Names:
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No Intervention: Control Group: RARP without hypothermia
These patients will receive standard of care only for RARP surgery.
They will not receive the UroCool investigational device.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Improved return of overall continence.
Time Frame: 90 days post RARP
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The primary objective of the study is an improved return of overall continence measured at 90 days post RARP surgery.
A favorable outcome would be improved overall continence in the RARP with hypothermia group versus the RARP without hypothermia group.
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90 days post RARP
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Faster return to continence.
Time Frame: 30, 60 and 90 days
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The secondary objective of the study is to see if men will achieve a return to continence faster if treated with hypothermia.
This will be assessed at 30, 60 and 90 days.
A favorable outcome would be a reduced time to continence in the RARP with hypothermia group versus the RARP without hypothermia group.
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30, 60 and 90 days
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Reduction of overall severe incontinence
Time Frame: 90 days, 6 months and 12 months
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The third objective is to assess reduction of overall severe incontinence.
Severe incontinence is defined as the need for 3 or more pads in a 24 hour period.
This will be assessed at 90 days, 6 and 12 months.
A favorable outcome would be a reduction of overall severe incontinence in the RARP with hypothermia group versus the RARP without hypothermia group.
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90 days, 6 months and 12 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Thomas Ahlering, MD, UC Irvine
- Study Director: Anthony M Mullin, MD, MDDR, Philips Healthcare/InnerCool BU
Publications and helpful links
General Publications
- Liss MA, Skarecky D, Morales B, Ahlering TE. The application of regional hypothermia using transrectal cooling during radical prostatectomy: mitigation of surgical inflammatory damage to preserve continence. J Endourol. 2012 Dec;26(12):1553-7. doi: 10.1089/end.2012.0345. Epub 2012 Nov 15.
- Finley DS, Chang A, Morales B, Osann K, Skarecky D, Ahlering T. Impact of regional hypothermia on urinary continence and potency after robot-assisted radical prostatectomy. J Endourol. 2010 Jul;24(7):1111-6. doi: 10.1089/end.2010.0122. Erratum In: J Endourol. 2010 Sep;24(9):1541.
- Huynh LM, Skarecky D, Porter J, Wagner C, Witt J, Wilson T, Lau C, Ahlering TE. A Randomized Control Trial Of Anti-Inflammatory Regional Hypothermia On Urinary Continence During Robot-Assisted Radical Prostatectomy. Sci Rep. 2018 Nov 5;8(1):16352. doi: 10.1038/s41598-018-34657-4.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
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
Keywords
Other Study ID Numbers
Other Study ID Numbers
- IT 04-200
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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