Efficacy of RestoreX Penile Traction Therapy In Preserving Erectile Function Post-Prostatectomy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background and Preliminary Data
The treatment of prostate cancer results in several known sexual dysfunctions/risks, including erectile dysfunction, orgasmic dysfunction, ejaculatory dysfunction, penile curvature (Peyronie's disease), and reduced penile length. Although all forms of prostate cancer treatment are associated with many of these changes, prostatectomy currently has the most data available on sexual function outcomes. Among the dysfunctions, erectile dysfunction has remained a very challenging adverse effect without effective preventative therapies. Specifically, prior randomized controlled trials evaluating the efficacy of PDE5 inhibitors (vardenafil and tadalafil) have failed to demonstrate improved erectile function preservation post-operatively.
Recently, out team conducted a single-center randomized, controlled trial evaluating the efficacy of a novel penile traction therapy (PTT) device, RestoreX at preventing penile length loss post-prostatectomy. In addition to meeting the primary outcome of achieving improved penile length compared to controls, the study unexpectedly demonstrated improvements in erectile function in the treatment group compared to controls. Results were also consistent with two other prior randomized, controlled trials, one of which demonstrated improved erectile function in men with Peyronie's Disease and the other in men with diabetes mellitus (unpublished).
As these findings represent the first known therapy which resulted in preserved erectile function post-prostatectomy, we sought to perform a larger, multi-center study in an attempt to confirm or refute findings.
Investigational Device
RestoreX is a PTT device developed by PathRight Medical using technology licensed from the Mayo Clinic. The device is classified as class I (orthotic) and does not require clinical trials to prove safety or efficacy. Mayo Clinic has previously performed 3 randomized controlled trials which have confirmed the safety of the device as well as efficacy in improving erectile function and penile length in various cohorts of men.
The device has two functional aspects. The first is the ability to provide direct traction on the penis. The second is the ability to provide counter-bending forces, to treat conditions such as Peyronie's disease (bent penis). In the current study, only the direct traction aspects of the device will be utilized.
Study Rationale
PTT with Restorex has been shown to improve erectile function in several clinical scenarios, including in men with Peyronie's disease, men with diabetes mellitus (unpublished), and post-prostatectomy. As no therapy has ever been shown to improve erectile function or prevent loss of erectile function post-prostatectomy, we felt that there was significant clinical value in performing a large, multi-center, randomized, controlled trial to affirm or refute the efficacy of Restorex PTT in preserving erectile function post-prostatectomy.
Potential Benefits
There are several anticipated benefits to using PTT following prostatectomy. As loss of penile length results in several issues including loss of sexual function, cosmetic concerns, and difficulty in maintaining hygiene (incontinence resulting in yeast infections), the ability to maintain or restore length post-prostatectomy may mitigate these issues. Our team has previously demonstrated that Restorex PTT significantly improved penile length post-prostatectomy. Although this is an anticipated beneficial effect of therapy, we will not be specifically evaluating this outcome in the current study.
In addition to improved penile length, our prior investigations have demonstrated preserved erectile function in men who received PTT with Restorex post-prostatectomy compared to controls. And among all patients in the three prior randomized, controlled trials evaluating Restorex, no significant or long-term adverse events were reported, highlighting the safety of the therapy.
Anticipated Duration of the Clinical Investigation
The overall study will be scheduled for 3 years, to permit adequate time for enrollment and follow-up. The intervention phase will include 5 months of randomized treatment (for the treatment arm), and 3 months of open label treatment (for all arms).
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Landon Trost, MD
- Phone Number: 801-655-0015
- Email: landontrost@gmail.com
Study Locations
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Arizona
-
Phoenix, Arizona, United States, 85054
- Recruiting
- Mayo Clinic Arizona
-
Contact:
- Clinical Trials Referral Office
- Phone Number: 855-776-0015
- Email: mayocliniccancerstudies@mayo.edu
-
Contact:
- Research Coordinator
- Phone Number: 480-574-1782
-
-
Illinois
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Chicago, Illinois, United States, 60611
- Recruiting
- Northwestern University
-
Contact:
- Sophia Kallas, BA
- Phone Number: 312-694-0633
- Email: sophia.kallas@northwestern.edu
-
Contact:
- Nikki Hubbard, BA
- Phone Number: 312-694-0611
- Email: nikki.hubbard@northwestern.edu
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-
New Jersey
-
Newark, New Jersey, United States, 07103
- Recruiting
- University Hospital
-
Contact:
- Evan Kovac, MD
- Phone Number: 973-972-7162
- Email: ek752@njms.rutgers.edu
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Contact:
- Saharsh Patel, MS
- Phone Number: 973-561-7047
- Email: ssp186@gsbs.rutgers.edu
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Utah
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Orem, Utah, United States, 84057
- Recruiting
- The Male Fertility and Peyronie's Clinic
-
Sub-Investigator:
- Holli Burgon
-
Contact:
- Landon Trost, MD
- Phone Number: (888) 655-0015
- Email: trost.landon@mfp.clinic
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Undergoing bilateral nerve-sparing prostatectomy
- >18 years old
- Have a regular sexual partner for at least 6 months prior to study enrollment
Exclusion Criteria:
- Requiring adjuvant radiation therapy or androgen deprivation / androgen blockade post-operatively (by the time of enrollment)
- Baseline severe erectile dysfunction as measured by the IIEF-EFD
- Urethral complications from prostatectomy at the time of baseline visit including contrast extravasation, anastomotic dehiscence of vesicourethral anastomosis, need for re-doing of vesicourethral anastomosis intra-operatively
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- 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: Treatment Arm
Men will begin utilizing PTT 30-60 minutes daily for 5-7 days weekly beginning 1 month post-prostatectomy until 6 months.
After 6 months, they will have the option to continue to use the therapy for 3 additional months or discontinue at their discretion.
|
Study participants are recommended utilize the device for 30-60 minutes, 5-7 days a week starting at 1 month post-prostatectomy and continuing until 6 months.
Both the treatment and control arms will be allowed to use the therapy from 6-9 months post-prostatectomy (open label phase).
Only straight traction will be used (no counterbending).
|
|
Active Comparator: Control
Men will not utilize PTT for the first 6 months post-prostatectomy.
Beginning at 6 months, they may utilize PTT if they desire (open label) until 9 months post-prostatectomy.
|
Both the treatment and control arms will be allowed to use the therapy from 6-9 months post-prostatectomy (open label phase).
Only straight traction will be used (no counterbending).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Erectile Function Post-Prostatectomy
Time Frame: 6 months
|
Compare erectile function between treatment and control cohorts, as assessed by the International Index of Erectile Function, Erectile Function Domain (IIEF-EFD) at 6-months post-prostatectomy.
IIEF-EFD scores 1-30, with higher scores representing better function.
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Non-erectile function domains of the International Index of Erectile Function
Time Frame: 6 months
|
Compare the non-erectile function domains of the International Index of Erectile Function between cohorts.
This represents 4 additional scales, with min/max being 0-10, 0-10, 0-15, and 0-10; higher scores indicated better function.
|
6 months
|
|
International Index of Erectile Function from baseline to 6 months
Time Frame: 6 months
|
Compare International Index of Erectile Function subdomains within cohorts from baseline to 6 months.
Scale 1-30, with higher scores representing better outcomes.
|
6 months
|
|
Adverse events at 3 months
Time Frame: 3 months
|
Evaluate number of participants reporting adverse events at 3 months.
|
3 months
|
|
Adverse events at 6 months
Time Frame: 6 months
|
Evaluate number of participants reporting adverse events at 6 months
|
6 months
|
|
Adverse events at 9 months
Time Frame: 9 months
|
Evaluate number of participants reporting adverse events at 9 months
|
9 months
|
|
International Index of Erectile Function from baseline to 9 months
Time Frame: 9 months
|
Compare International Index of Erectile Function domains at 9 months compared to baseline.
Scale is 1-30 with higher scores indicating better function.
|
9 months
|
|
International Index of Erectile Function between groups at 9 months
Time Frame: 9 months
|
Compare International Index of Erectile Function domains at 9 months between cohorts (treatment arm, control).
Scale is 1-30 with higher scores indicating better function.
|
9 months
|
|
Subjective questionnaire at 6 months
Time Frame: 6 months
|
Compare subjective questionnaire results between cohorts at 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
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 (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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CUREPD 104
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- CSR
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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