Treatment of Chronic Pelvic Pain Due to Endometriosis by Transcutaneous Auricular Vagus Nerve Stimulation (Stim-Endom)
6-10% of women of childbearing age suffer from endometriosis, which is mainly manifested by dysmenorrhea, non-menstrual pelvic pain and dyspareunia. Several treatment strategies, including surgical ones, are proposed but they are sometimes insufficient because endometriosis-related pain is frequently accompanied by sensitization. Endometriosis surgery, when indicated, is therefore changeably effective, even though the lesions have been completely resected. Patients therefore consult Pain Units seeking for the effective treatment as the pain persist even after surgical management of endometriosis.
Vagus nerve stimulation is a non-invasive technique that includes an anti-inflammatory effect and a modulation of neurotransmitter production (adrenaline, norepinephrine; serotonin, acetylcholine). Yuan and Silberstein published a general review on the technique. Migraine and depression are one of the selected indications. In addition, Napadow et al. published favourable results in a short series of patients with chronic pelvic pain. The Investigators of this study have treated some patients with this technique with a result deemed satisfactory which leads to propose a randomized study to confirm this impression.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Mireille MICHEL-CHERQUI, MD
- Phone Number: 0033 1 46 25 29 85
- Email: drci.promotion@hopital-foch.com
Study Locations
-
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Île-de-France Region
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Suresnes, Île-de-France Region, France, 92150
- Recruiting
- Hôpital Foch
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Contact:
- Mireille Michel-cherqui, MD
- Email: drci.promotion@hopital-foch.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Women aged >= 15 years
- With chronic pelvic pain and/ or dysmenorrhoea and/ or dyspareunia
- Who has been cared for by a gynecologist in one of the institutions participating in the study
- Diagnosed with endometriosis
- Having signed an informed written consent
- Affiliated to a health insurance scheme
Exclusion Criteria:
- contraindication to the use of transcutaneous auricular vagus nerve stimulation (cardiac pathology, asthmatic patient)
- pregnant or breastfeeding women
- patient undergoing in vitro fertilization
- associated pathology requiring long-term analgesic treatment
- patient with atria trans vagal neurostimulation in the 12 months prior to inclusion
- patient deprived of liberty or under guardianship
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Transcutaneous auricular vagus nerve stimulation
A 30-minute session twice a day during 3 months of transcutaneous auricular vagus nerve stimulation using the TENS Eco Plus. Standard treatment will be continued by the patients of this arm. |
Transcutaneous Auricular Vagus Nerve Stimulation has an eartip connected to an external stimulator. The device used in this study is the TENS Eco Plus commercialized by Schwa Medico and European Compliance (CE) marked. The electrode is positioned in the cymba concha of the left ear. |
|
No Intervention: Standard treatment
Patients of this arm will continue their standard treatment.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of symptoms related to the pelvic pain
Time Frame: 3 months after enrolment
|
Self assessement of change using Patient's Global Impression of Change (PGIC) scale in which patients rate the improvement of their symptoms related to their pelvic pain from "No change or it get worse" to "A great deal better, and a considerable improvement that has made all the difference" .
A favorable result will be "Better, and a definite improvement that has made a real and worthwhile difference" or "A great deal better, and a considerable improvement that has made all the difference"
|
3 months after enrolment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy on pain
Time Frame: Day 1 and 3 months after enrolment
|
Self assessement of pain using Endometriosis-associated pelvic pain scale on which patients rate their current pain intensity from 0 "No pain" to 10 "worst possible pain"
|
Day 1 and 3 months after enrolment
|
|
Efficacy on severity of patient's symptoms
Time Frame: Day 1 and 3 months after enrolment
|
Physician assessement of severity of patient's symptoms using Global Clinical Impressions-Severity scale on which physicians rate the severity of patient's symptoms from "not evaluated" to "Among the sickest patients"
|
Day 1 and 3 months after enrolment
|
|
Efficacy on quality of life
Time Frame: Day 1 and 3 months after enrolment
|
Self assessement of quality of life using Endometriosis Health Profile-5
|
Day 1 and 3 months after enrolment
|
|
Efficacy on quality of life
Time Frame: Day 1 and 3 months after enrolment
|
Self assessement of quality of life using EQ-5D scale
|
Day 1 and 3 months after enrolment
|
|
Efficacy on Anxiety
Time Frame: Day 1 and 3 months after enrolment
|
Self assessement of anxiety using the Hospital Anxiety and Depression scale
|
Day 1 and 3 months after enrolment
|
|
Efficacy on gynecological and pelvic pain symptoms
Time Frame: Day 1 and 3 months after enrolment
|
Self assessement of gynecological and pelvic pain symptoms using ENDOL-4D questionnaire
|
Day 1 and 3 months after enrolment
|
|
Efficacy on gynecological and pelvic pain symptoms
Time Frame: D1 and 3 months after enrolment
|
Self assessement of gynecological and pelvic pain symptoms using KESS questionnaire
|
D1 and 3 months after enrolment
|
|
General efficacy of the device Transcutaneous Electronic Neuro Stimulation TENS Eco Plus
Time Frame: 3 months after enrolment
|
Self assessement of satisfaction using a satisfaction questionnaire involving satisfaction, adherence to treatment sessions and ease of use of the device
|
3 months after enrolment
|
|
Collection of possible side effects
Time Frame: 3 months after Enrolement
|
collection of vagal malaise, nausea and vomiting
|
3 months after Enrolement
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Marc FISCHLER, MD PhD, Hôpital Foch, Suresnes
- Principal Investigator: Mireille MICHEL-CHERQUI, MD, Hôpital Foch, Suresnes
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
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
Other Study ID Numbers
Other Study ID Numbers
- 2019-0057
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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