- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00977652
Percutaneous Tibial Nerve Stimulation for the Treatment of Fecal Incontinence (TENSIA)
Short Term Efficacy of Percutaneous Tibial Nerve Stimulation for the Treatment of Fecal Incontinence:Randomized Controlled Study
Fecal incontinence is a major public health issue since 10% of the French population aged 45 has to deal with it. Different treatments exist and have already been evaluated, like the sacral nerve stimulation (SNS) which has proved to be efficient in 75 to 100% of the anal incontinence patients without significant sphincteric lesions or rectal prolapse. However, the treatment is expensive and can have side effects. Moreover, about 20 to 30% of the patients can develop a resistance to the SNS only a few months following the definite implantation. Yet the development of the posterior tibial nerve stimulation (PNTS) offers a new perspective. It consists in stimulating the same metameric area as the sacral nerves. It is regularly used for the treatment of urinary incontinence caused by overactive bladder. It is a non-invasive technique, causing but a few side effects. A preliminary study showed that 7 in 10 incontinent patients saw an improvement when treated with PTNS.
Purpose:
The aim of this study is to analyse and evaluate the PTNS technique in the short term as a treatment of anal incontinence. It is done through the means of a multi-centric prospective randomized study.
Patients:
Will be included: all patients followed for anal incontinence (either with liquid or solid stools) having at least one accident a month for 3months, and who are not diagnosed with colorectal lesions and who are without anal or rectal significant anatomic anomalies, without rectal prolapse, and who have failed to respond to medical treatment (such as medicine or perineal reeducation). The main criterium to analyze the efficiency will be the number of fecal incontinence episodes on a bowel diary. The investigators aim to incorporate 144 patients, that is 72 in each group. 12 centers will take part in this study, that will last 2 years and 3 months. They are the centers of: Bordeaux, Clermont-Ferrand, Grenoble, Lyon, Marseille, Nancy, Nantes, Paris, Diaconesses-Croix,Paris Rothschild, Rennes, Rouen, and Toulouse.
Method:
The PTNS consists in setting two electrodes on the posterial tibial nerve pathway. The electrodes are connected to an external stimulator. After having drawn lots, patients will be treated for 3months either with effective stimulation (frequency: 14hz; impulse duration: 210usec;intensity:sensibility threshold), or with shame stimulation (intensity: 0mAmp). There will be two daily sessions of stimulation (effective, or shame), 20 min each. A pre-treatment assessment will be established, composed of a stool diary, a Cleveland Clinic score, a Fecal Incontinence Quality of Life scale and an anorectal manomety, that will all be repeated by the end of the treatment.
Expected Results:
The investigators hope to prove the short term efficacy of the PTNS on anal incontinence patients.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Rouen, France, 76000
- Leroi
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- fecal incontinence, refractory to medical treatment,for more than 3 months,with at least one episode of anal incontinence and/or urgency per month
- patient with no knowledge of cutaneous stimulation
- patients with NHS
Exclusion Criteria:
- older than 18 years old
- pregnancy
- implanted stimulator
- cutaneous lesion
- cutaneous anesthesia
- patients without oral contraception
- Guardianship and curatorship
- fecal incontinence secondary to anorectal malformation, surgical sequelae, significative sphincteric lesion leading to repair at a first time, rectal prolapse, active neurological disease
- patient already treated by sacral nerve stimulation or stimulated graciloplasty, artificial bowel sphincter, radiofrequency
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Active stimulation
Percutaneous posterior tibial nerve stimulation
|
percutaneous posterior tibial nerve stimulation with following parameters: frequency: 14hz; impulse duration: 210usec;intensity:sensibility threshold during 3 months
|
Sham Comparator: sham stimulation
Inefficient percutaneous posterior tibial nerve stimulation
|
Same location with the same device than active stimulation but amplitude of stimulation = 0
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
fecal incontinence episode per week
Time Frame: three months
|
three months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
cleveland clinic score FIQL score analogic visual scale urinary score and anorectal manometry
Time Frame: 3 months
|
3 months
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2008/070/HP
- CPP-2008/032
- RCB-2008-A01227-48
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.
Clinical Trials on Fecal Incontinence
-
Batterjee Medical CollegeBenha UniversityCompleted
-
Badr UniversityCompletedFecal Incontinence in ChildrenEgypt
-
Hospital Mutua de TerrassaCompletedGas Incontinence | Soilings, Fecal
-
RDD Pharma LtdWithdrawnIdiopathic Fecal IncontinenceIsrael
-
Nantes University HospitalCompletedConstipation Aggravated | Fecal Incontinence With Fecal UrgencyFrance
-
Queen Mary University of LondonCompletedBowel Incontinence | Faecal Incontinence
-
University of AarhusUniversity of Tromso; Hvidovre University HospitalCompletedFecal Incontinence | Faecal IncontinenceDenmark
-
NICHD Pelvic Floor Disorders NetworkEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompletedFecal Incontinence | Bowel IncontinenceUnited States
-
Andalusian Initiative for Advanced Therapies -...Iniciativa Andaluza en Terapias AvanzadasCompleted
-
Massarat ZutshiCook Group IncorporatedTerminatedFecal Incontinence | Anal IncontinenceUnited States
Clinical Trials on active stimulation
-
Tianjin Anding HospitalChinese Academy of SciencesEnrolling by invitationSchizophrenia Negative TypeChina
-
BrainsGateTerminatedAcute Ischemic StrokeSpain, Germany, United States
-
Nottingham University Hospitals NHS TrustUniversity of Nottingham; Neurotherapeutics LtdCompletedTourette Syndrome | Chronic Tic DisorderUnited Kingdom
-
Centre Hospitalier Henri LaboritMinistry of Health, FranceCompletedObsessive-Compulsive DisorderFrance
-
University of FloridaNational Institute of Neurological Disorders and Stroke (NINDS); MedtronicRecruitingParkinson Disease | Dystonia | Essential TremorUnited States
-
University of Sao PauloBrain & Behavior Research FoundationCompletedDepression, BipolarBrazil
-
Assistance Publique - Hôpitaux de ParisNot yet recruitingAxial SpondyloarthritisFrance
-
VA Office of Research and DevelopmentCompleted
-
Institut National de la Santé Et de la Recherche...Completed
-
Andrew KrystalRecruitingMajor Depressive DisorderUnited States