Conservative Treatment of Postprostatectomy Incontinence

The primary purpose of this study is to test the effectiveness, impact on quality of life, and durability of non-surgical therapies for incontinence persisting at least one year after surgery. The study is a a prospective, controlled, randomized trial comparing an 8-week, multi-component behavioral training program (pelvic floor muscle exercises, self-monitoring with bladder diaries, regular office visits, bladder control techniques, and fluid management) to the same program with the addition of biofeedback and pelvic muscle electrical stimulation.

Study Overview

Detailed Description

The primary purpose of this project is to test the effectiveness, impact on quality of life, and durability of conservative therapies for persistent post-prostatectomy urinary incontinence in a prospective, controlled, randomized trial comparing an 8-week, multi-component behavioral training program (pelvic floor muscle exercises, self-monitoring with bladder diaries, regular office visits, bladder control techniques, and fluid management) to the same program with the addition of biofeedback and pelvic muscle electrical stimulation.

The second purpose of the study is to examine and compare the cost-effectiveness of the 8-week, multi-component behavioral training program to the same program with the addition of biofeedback and pelvic floor electrical stimulation.

Prostate cancer is the most common internal cancer in men in the United States. The most common treatment for early disease is radical prostatectomy, the removal of the prostate gland. The two most common sequelae of prostatectomy are incontinence and erectile dysfunction. The incontinence improves and often resolves in the first year after prostatectomy, but surveys of patients show that 40% of men have incontinence severe enough to require pads 1 and 2 years after their surgery. There are currently no randomized, controlled studies of non-surgical treatments for persistent post-prostatectomy incontinence.

Study Type

Interventional

Enrollment (Actual)

208

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

    • Alabama
      • Birmingham, Alabama, United States, 35294
        • University of Alabama at Birmingham

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

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  1. Involuntary loss of urine that started immediately after radical prostatectomy and has persisted for at least one year.
  2. One-week bladder diary with interpretable data and at least two incontinence episodes

Exclusion Criteria:

  1. Any unstable medical condition, particularly decompensated congestive heart failure, history of malignant arrhythmias, or unstable angina
  2. Cardiac pacemaker or implanted cardiac defibrillator
  3. Current use of anticholinergic agents for detrusor instability
  4. Folstein's Mini-Mental State Exam score below 24 (impaired mental status)
  5. One-week bladder diary with continual leakage - defined as always being damp or wet or unable to quantitate individual accidents.
  6. Poorly controlled diabetes, defined as (glycosylated hemoglobin > 9 within last 3 months).
  7. Hematuria on microscopic examination. Enrollment will be permitted after urologic evaluation.
  8. Urodynamic evaluation: Post-void residual volume greater than 200 mL

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Behavioral Therapy
Behavioral Therapy (Pelvic floor muscle training, bladder control strategies)
Pelvic Floor Muscle Exercises and Bladder control strategies
Experimental: Behavioral Therapy Plus Technologies
Behavioral therapy plus technologies (home pelvic floor electrical stimulation and biofeedback)
Pelvic Floor Muscle Exercises and Bladder control strategies
Pelvic Floor Electrical Stimulation daily for 8 weeks
Pelvic Floor Muscle training via biofeedback
Placebo Comparator: Placebo Comparator
No treatment control
No treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change in Incontinence Episodes on Bladder Diary
Time Frame: 2 months
[(Baseline incontinence episodes minus 2-month incontinence episodes)/baseline incontinence episodes] x 100%
2 months
Percent Change in Incontinence Episodes Per Week on Bladder Diary
Time Frame: 1 year
[(Baseline incontinence episodes minus 12-month incontinence episodes)/baseline incontinence episodes] x 100%
1 year

Collaborators and Investigators

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

Investigators

  • Principal Investigator: Patricia S Goode, MD, University of Alabama at Birmingham

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

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

August 1, 2003

Primary Completion (Actual)

September 1, 2008

Study Completion (Actual)

August 1, 2011

Study Registration Dates

First Submitted

September 13, 2005

First Submitted That Met QC Criteria

September 13, 2005

First Posted (Estimate)

September 21, 2005

Study Record Updates

Last Update Posted (Estimate)

April 11, 2016

Last Update Submitted That Met QC Criteria

March 21, 2016

Last Verified

March 1, 2016

More Information

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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