Filling and Emptying Cystometries ("Backwards Cystometry"): a Feasibility and Validation Study

September 24, 2019 updated by: Gérard Amarenco, Pierre and Marie Curie University

Filling and Emptying Cystometries: a Feasibility and Validation Study in Order to Simplify the Manometric Follow-up of Overactive Detrusor in Neurological Patients Under Anticholinergic or Botulinum Toxin Injections.

This study evaluate the feasibility and the accuracy of an emptying cystometry in order to simplify the manometric follow-up of overactive detrusor in neurological patients under anticholinergic or botulinum toxin injections.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Bladder pressure assessment is necessary for the diagnosis, the prognostic assessment and the management of neurogenic bladder. High bladder pressures increase the rate of urological complications and mortality in patients with neurogenic bladder. Thus many treatments are proposed in order to improve bladder compliance and reduce uninhibited detrusor contractions (anticholinergic drugs, botulinum toxin injections, cystoplasty, sacral neuromodulation, beta-3-agonist, posterior tibial nerve stimulation).

Clinical data, symptoms scales, quality of life questionnaires, renal ultrasound, biological tests of renal function and urodynamic studies are used to control the treatment efficacy of neurogenic lower urinary tract dysfunction. Filling cystometry is the usual way to record bladder pressure. Urodynamic techniques using external pressure transducers (microtip, air-filled or fluid-perfused catheters) connected to the patient with fluid-filled lines are recommended. This multichannel cystometry is performed in a specialized department with the inconvenience of delays for appointments and cost of the urodynamic assessment. Moreover, only some parameters are important and are taken in account in the follow-up of these neurogenic bladders: bladder capacity, bladder compliance and maximum detrusor pressure at the end of the filling phase. All these parameters can be recorded with a self-assessment of bladder pressure at home with a very simple device made of 1) a self-intermittent catheter; 2) a three way stopcock; 3) a simple graduated tube. This device has in fact been used in the past to realize cystometries, in particular in the elderly subject. A such device should provide a monitoring in changes in bladder pressure in order to initiate adjustments in treatment sooner than would be achieved when patients are evaluated periodically but less frequently in the neurourology department. The early detection of high bladder pressures may avoid bladder deformation, reflux and upper tract deterioration. Moreover, the home control of appropriate bladder pressure may improve the patients' quality of live by reducing the constraint linked to the time-consuming specialized follow-up.

In this study, the investigators will test a reverse single channel cystometry performed just after a classical filling cystometry during the usual emptying by means of a device allowing serial bladder pressure measurements during the bladder emptying. In case of such a feasibility and a good precision of the reverse cystometry, the manometric follow-up of overactive detrusor in neurological patients under anticholinergic or botulinum toxin injections could be simplified.

The aim of this study is to assess the feasibility and the accuracy of sequential measurements of bladder pressure during the bladder emptying and to compare the evolution of bladder pressures during the emptying phase with the bladder pressures recorded during the filling phase.

Patients over 18 years old, consulting for lower urinary tract symptoms and performing an urodynamic examination with a cystometry in a tertiary center are included.

History, treatment and urodynamics data are recorded. Conventional supine multichannel cystometry with isotonic saline infused at 50ml/min (filling cystometry), conform to the International Continence Society (ICS) recommendations will be performed. At the end of the standard cystometry when the maximum cystometric capacity will be reached, if no micturition was obtained, urodynamic catheter was withdrawn and a CH12 urinary catheter will be introduced in the bladder according to the usual department procedure (usually, this catheter allows to empty the bladder). This catheter will be connected to a three-way stopcock. The second way of the stopcock will permit the emptying into a measuring container, graduated each 50ml. The third way of the stopcock will be connected via a tube extension to a rigid vertical 70cm tube (central venous pressure set) graduated each centimeter. The zero pressure of the vertical tube will be set at the upper edge of the symphysis pubis. For measuring the bladder pressure at the maximum cystometric capacity, the valve will be open between the bladder and the graduated tube, manometric data will be derived by observing the rise of the column of fluid in the centimeter scale tube. This procedure will be repeated every 50ml until bladder full emptying.

The investigators will compared each bladder pressure measures every 50ml during the "backwards cystometry" with each bladder pressure measured every 50ml from the maximum capacity during the filling cystometry.

Primary outcome is the agreement between the two cystometries evaluated using a kappa coefficient.

Secondary outcome is the correlation between the pressures during the two cystometries.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
11

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

  • France
      • Paris, France, 75020
        • Department of Neuro-urology, Tenon 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

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients consulting for an urodynamic assessment in a tertiary center in neuro-urology

Description

Inclusion Criteria:

  • Follow in neuro-urology for lower urinary tract symptoms
  • Appointment for urodynamic assessment

Exclusion Criteria:

  • detrusor overactivity
  • micturition during or at the end of the filling cystometry

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

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Patients enrolled

Patients over 18 years old, consulting for lower urinary tract symptoms and performing an urodynamic examination with a cystometry in a tertiary center are included.

First pressure measurement in the bladder during the classic cystometry. Second measurement of bladder pressures during the bladder emptying.
Other: Pressure measurement
Observational study No intervention, only fragmenting the emptying of the bladder

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Agreement
Time Frame: 1 Day : during the urodynamic assessment
Agreement between the two cystometries evaluated using a kappa coefficient.
1 Day : during the urodynamic assessment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Correlation
Time Frame: 1 Day : during the urodynamic assessment
Correlation between the pressures during the two cystometries.
1 Day : during the urodynamic assessment

Collaborators and Investigators

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

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Pierre and Marie Curie University

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)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 31, 2017

Primary Completion (ACTUAL)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 28, 2017

Study Completion (ACTUAL)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 29, 2017

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 16, 2017

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 16, 2017

First Posted (ACTUAL)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 21, 2017

Study Record Updates

Last Update Posted (ACTUAL)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 25, 2019

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 24, 2019

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • P GREEN 01

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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