Standardization of Lead Placement for Sacral Neuromodulation. Part 1

October 13, 2019 updated by: Donald Vaganée, Universiteit Antwerpen

Pelvic Floor EMG Monitoring as Tool to Improve Patient Selection and Outcome - Standardization of Lead Placement for Sacral Neuromodulation.

Retrospective case-control study.

A substantial number of patients do not respond favourably to sacral neurostimulation (SNS) although clinically, they appear to have the same lower urinary tract dysfunction characteristics as the ones with good responses. This may be due to methodological issues (lead position) or patient selection. The purpose of this study is to improve and standardize lead position, in order to increase the patient response to test stimulation and to SNS treatment, and to decrease adverse events.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Antwerp
      • Edegem, Antwerp, Belgium, 2650
        • Antwerp University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Male or female aged ≥18 years and competent to provide consent
  2. Minimum 3 months of self-reported OAB symptoms or self-reported obstructive LUTS in addition to confirmed non-obstructive urinary retention on UDO
  3. Failed, or are not a candidate for more conservative treatment (i.e., pelvic floor training, biofeedback, behavioral modification, oral pharmacotherapy)
  4. Willing to discontinue OAB medications for 2 weeks prior to the implant and for the entire study period
  5. Able to thoroughly fill in all questionnaires, voiding diaries and office visits for device programming and clinical evaluations before the TLP, 3 weeks after TLP and 6 weeks, 6 months and 1 year after implantation of definitive IPG.

Exclusion Criteria:

  1. Current of prior evidence of primary stress incontinence or mixed incontinence where the stress component overrides the urgency component
  2. Any neurological condition that may interfere with normal bladder function, including stroke, multiple sclerosis, Parkinson's disease, clinically significant peripheral neuropathy, or spinal cord injury (e.g., paraplegia)
  3. Urinary tract mechanical obstruction including but not limited to Benign Prostatic Hyperplasia (BPH)
  4. Treatment of bladder or pelvic floor dysfunction with botulinum toxin (Botox ®) or surgery in past 12 months
  5. Unable to toilet self and have and maintain good personal hygiene
  6. Unable to provide clear, thoughtful responses to questions and questionnaires
  7. Urinary tract, bladder or vaginal infection or inflammation
  8. Hematuria, and absence of an elaborate diagnostic work-up
  9. Severe or uncontrolled diabetes (A1C > 8, documented in the last 3 months) or diabetes with peripheral nerve involvement
  10. Allergy to local anesthetic or adhesives
  11. Bleeding disorder or on an anticoagulant that cannot be stopped for 3 days before the implant
  12. Pregnant, lactating, planning to become pregnant, given birth in the past 12 months, or female of child-bearing potential and not practicing a medically-approved method of birth control
  13. Skin lesions or compromised skin at the implant or stimulation site
  14. Use of investigational drug or device therapy or participation in any study involving or impacting gynecologic, urinary or renal function within past 4 weeks
  15. Passive implants (e.g., prostheses) are allowed, but no implanted metal should be at the Neurostimulator implant site
  16. Knowledge of planned MRIs, diathermy, or high output ultrasonic exposure
  17. Presence of a documented condition or abnormality that could compromise the safety of the patient
  18. Any psychiatric or personality disorder at the discretion of the study physician
  19. Interstitial cystitis or bladder pain syndrome as defined by the EAU guidelines
  20. Life expectancy of less than 1 year

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: DIAGNOSTIC
  • Allocation: NON_RANDOMIZED
  • Interventional Model: SINGLE_GROUP
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: OAB
Patients with overactive bladder on sacral neuromodulation.
Define pelvic floor EMG template measured by probe
EXPERIMENTAL: NOUR
Patients with non-obstructive urinary retention on sacral neuromodulation.
Define pelvic floor EMG template measured by probe

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
EMG activity of pelvic floor muscles in OAB patients and NOUR patients already on SNM
Time Frame: 1 day
Latency and amplitude of pelvic floor measured by EMG probe
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Study Director: Stefan De Wachter, MD PhD FEBU, University Hospital, Antwerp
  • Principal Investigator: Donald Vaganée, University Hospital, Antwerp

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

September 1, 2017

Primary Completion (ANTICIPATED)

August 1, 2022

Study Completion (ANTICIPATED)

August 1, 2022

Study Registration Dates

First Submitted

May 10, 2017

First Submitted That Met QC Criteria

June 20, 2017

First Posted (ACTUAL)

June 21, 2017

Study Record Updates

Last Update Posted (ACTUAL)

October 15, 2019

Last Update Submitted That Met QC Criteria

October 13, 2019

Last Verified

October 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • B300201523497 Part 1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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