Viberect Penile Vibratory Stimulation to Enhance Recovery of Erectile Function and Urinary Continence Post-Prostatectomy

Study of Non-Invasive Viberect® Penile Vibratory Stimulation Regimen to Enhance Recovery of Erectile Function/Rigidity and Urinary Control/Continence After Nerve Sparing Radical Prostatectomy (RP) for Clinically Localized Prostate Cancer.

The purpose of this study is to evaluate whether using penile vibratory stimulation with the Viberect handheld device can help the recovery of erections and urinary control after radical prostatectomy.

Study Overview

• Status: Withdrawn
• Conditions: Erectile Dysfunction Following Radical Prostatectomy; Urinary Incontinence of Non-organic Origin
• Intervention / Treatment: Device: Viberect device

Detailed Description

Prostate cancer screening programs have led to thousands of sexually healthy and continent men being diagnosed with prostate cancer every year. Recent literature suggests that up to 80% of these cancers are confined to the prostate gland. Currently, radical prostatectomy (RP) remains the best option for management of clinically localized prostate cancer in men with life expectancy greater than 10 years. Despite providing optimal cancer control, surgery can lead to quality of life (QOL) problems such as urinary incontinence and erectile dysfunction (ED). Refinement of surgical technique have improved sexual and continence outcomes; however erectile function lags behind other QOL measures by 1-2 years, and quality of returning erections is often inferior. This can have profound biological, marital, and psychological consequences in potent men undergoing RP.

ED is the inability to develop and maintain an erection for satisfactory sexual intercourse or activity. ED after nerve-sparing RP is related to a certain degree with functional impairment of cavernous nerves (CN) that travel along the prostate to the penis. This neuropraxia can last as long as 2 years. Pro-erectile nerve stimulus is vital for replenishment of corporal oxygen supply and other metabolic needs. Several histological analyses have demonstrated decreased smooth muscle number, cell-cell contact, venous leakage, collagen deposition, and additional harmful effects to corporal tissue after injury to CN.

Awaiting post-surgical neuropraxia recovery, urologists have proposed a proactive approach to use of oral, intraurethral or injectable pharmacotherapy, neuromodulation, or vacuum-assisted regimens in erectile rehabilitation programs. Several studies demonstrate variable functional improvement in erectile function. Unfortunately, prohibitive costs of medications, poor response, and pain from injectables or intraurethral application often lead to high dropout rates.

In addition to ED, a significant proportion of men after surgery develop and suffer from urinary incontinence (Stress, Urge, Mixed) requiring wearing pads with bothersome complaints persisting for months, even years after RP.

The primary objective is to assess the role of penile vibratory stimulation by the Viberect device in enhancing the recovery of erectile function/rigidity and urinary continence after RP for clinically localized prostate cancer. The difference in penile length will be compared in each arm.

The secondary objective is to obtain a formal risk analysis (RA). Other objectives are to assess the ease of use and acceptability of vibratory stimulation at home.

• Study Type: Interventional
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Johns Hopkins Hospital
    • Frederick, Maryland, United States, 21701
      • Frederick Urology Specialists

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Patients with biopsy proven low/moderate risk prostate cancer (Gleason 3+3=6, 3+4=7, 3+2=5, 2+3=5, cT1c, cT2a, cT2b, preoperative prostatic specific antigen (PSA) less than 10)
• between ages 40-70
• preoperative IIEF (erectile function domain) score equal or greater than 20
• IPSS less than 10 and no urinary incontinence

Exclusion Criteria:

• Men with neurological disease
• IIEF score less than 20
• high risk prostate cancer (Gleason 4+3=7, 4+4=8, any Gleason 5, cT2c, cT3, PSA > 10)
• spinal cord injury
• history of transurethral resection of prostate (TURP) or other prostate ablative procedures
• history of priapism, pelvic neuropathy, penile skin lesions/ulcers
• inability to understand and demonstrate device use instructions.

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

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Viberect device; Men in this group will begin using the Viberect device 3 days after Foley catheter removal after surgery on a daily (or at least 4 times a week) basis for 7-10 minutes in a relaxed setting.	Device: Viberect device; Men who begin using the Viberect device 3 days after Foley catheter removal on a daily (or at least 4 times a week) basis for 7-10 minutes in a relaxed setting with sexual thoughts or foreplay for one year. Viberect method can be performed by the person's sexual partner.
No Intervention: No Viberect; Men in this group will not be provided with the Viberect device

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
change in erectile function	The International Index for Erectile Function (IIEF) questionnaire will be administered. This is a 15 item tool; 6 ask questions addressing Erectile function over the previous 4 weeks. Scores from 0-30 can be obtained in this domain. Scores are interpreted as follows: 0-6 = Severe dysfunction, 7-12 = Moderate dysfunction, 13-18 = mild-moderate dysfunction, 19-24 = mild dysfunction, 25-30 = No dysfunction	baseline to 6 weeks after first device use
change in erectile function	IIEF questionnaire will be administered. This is a 15 item tool; 6 ask questions addressing Erectile function over the previous 4 weeks. Scores from 0-30 can be obtained in this domain. Scores are interpreted as follows: 0-6 = Severe dysfunction, 7-12 = Moderate dysfunction, 13-18 = mild-moderate dysfunction, 19-24 = mild dysfunction, 25-30 = No dysfunction	baseline to 3 months after first device use
change in erectile function	IIEF questionnaire will be administered. This is a 15 item tool; 6 ask questions addressing Erectile function over the previous 4 weeks. Scores from 0-30 can be obtained in this domain. Scores are interpreted as follows: 0-6 = Severe dysfunction, 7-12 = Moderate dysfunction, 13-18 = mild-moderate dysfunction, 19-24 = mild dysfunction, 25-30 = No dysfunction	baseline to 6 months after first device use
change in erectile function	The International Index for Erectile Function (IIEF) questionnaire will be administered. This is a 15 item tool; 6 ask questions addressing Erectile function over the previous 4 weeks. Scores from 0-30 can be obtained in this domain. Scores are interpreted as follows: 0-6 = Severe dysfunction, 7-12 = Moderate dysfunction, 13-18 = mild-moderate dysfunction, 19-24 = mild dysfunction, 25-30 = No dysfunction	baseline to 9 months after first device use
change in erectile function	The International Index for Erectile Function (IIEF) questionnaire will be administered. This is a 15 item tool; 6 ask questions addressing Erectile function over the previous 4 weeks. Scores from 0-30 can be obtained in this domain. Scores are interpreted as follows: 0-6 = Severe dysfunction, 7-12 = Moderate dysfunction, 13-18 = mild-moderate dysfunction, 19-24 = mild dysfunction, 25-30 = No dysfunction	baseline to 12 months after first device use
change in erectile function	The Expanded Prostate Cancer Index Composite (EPIC) sexual assessment questionnaire will be administered. The tool has 9 questions about erectile function over the previous 4 weeks. It is scored from 9 - 43 with higher scores indicating greater dysfunction	baseline to 6 weeks after first device use
change in erectile function	The Expanded Prostate Cancer Index Composite (EPIC) sexual assessment questionnaire will be administered. The tool has 9 questions about erectile function over the previous 4 weeks. It is scored from 9 - 43 with higher scores indicating greater dysfunction	baseline to 3 months after first device use
change in erectile function	The Expanded Prostate Cancer Index Composite (EPIC) sexual assessment questionnaire will be administered. The tool has 9 questions about erectile function over the previous 4 weeks. It is scored from 9 - 43 with higher scores indicating greater dysfunction	baseline to 6 months after first device use
change in erectile function	The Expanded Prostate Cancer Index Composite (EPIC) sexual assessment questionnaire will be administered. The tool has 9 questions about erectile function over the previous 4 weeks. It is scored from 9 - 43 with higher scores indicating greater dysfunction	baseline to 9 months after first device use
change in erectile function	The Expanded Prostate Cancer Index Composite (EPIC) sexual assessment questionnaire will be administered. The tool has 9 questions about erectile function over the previous 4 weeks. It is scored from 9 - 43 with higher scores indicating greater dysfunction	baseline to 12 months after first device use
change in erectile function	The Erectile Hardness Score (EHS) questionnaire will be administered. it is a single item tool. It is scored from 1 to 4. 4 indicates attainment of full rigidity with ability to perform penetrative intercourse	baseline to 6 weeks after first device use
change in erectile function	The Erectile Hardness Score (EHS) questionnaire will be administered. it is a single item tool. It is scored from 1 to 4. 4 indicates attainment of full rigidity with ability to perform penetrative intercourse	baseline to 3 months after first device use
change in erectile function	The Erectile Hardness Score (EHS) questionnaire will be administered. it is a single item tool. It is scored from 1 to 4. 4 indicates attainment of full rigidity with ability to perform penetrative intercourse	baseline to 6 months after first device use
change in erectile function (EF)	The Erectile Hardness Score (EHS) questionnaire will be administered. it is a single item tool. It is scored from 1 to 4. 4 indicates attainment of full rigidity with ability to perform penetrative intercourse	baseline to 9 months after first device use
change in EF	The Erectile Hardness Score (EHS) questionnaire will be administered. it is a single item tool. It is scored from 1 to 4. 4 indicates attainment of full rigidity with ability to perform penetrative intercourse	baseline to 12 months after first device use
change in EF	Measurement of penile length from corona to dorsal glans penis in centimeters	baseline to 6 weeks after first device use
change in EF	Measurement of penile length from corona to dorsal glans penis in centimeters	baseline to 3 months after first device use
change in EF	Measurement of penile length from corona to dorsal glans penis in centimeters	baseline to 6 months after first device use
change in EF	Measurement of penile length from corona to dorsal glans penis in centimeters	baseline to 9 months after first device use
change in EF	Measurement of penile length from corona to dorsal glans penis in centimeters	baseline to 12 months after first device use

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
change in urinary control	The Expanded Prostate Cancer Index Composite (EPIC) urinary function assessment questionnaire will be administered. This is a 7 item tool assessing urinary function over the past 4 weeks. Higher scores indicate decreased urinary control	baseline to 6 weeks after first device use
change in urinary control	The Expanded Prostate Cancer Index Composite (EPIC) urinary function assessment questionnaire will be administered. This is a 7 item tool assessing urinary function over the past 4 weeks. Higher scores indicate decreased urinary control	baseline to 3 months after first device use
change in urinary control	The Expanded Prostate Cancer Index Composite (EPIC) urinary function assessment questionnaire will be administered. This is a 7 item tool assessing urinary function over the past 4 weeks. Higher scores indicate decreased urinary control	baseline to 6 months after first device use
change in urinary control	The Expanded Prostate Cancer Index Composite (EPIC) urinary function assessment questionnaire will be administered. This is a 7 item tool assessing urinary function over the past 4 weeks. Higher scores indicate decreased urinary control	baseline to 9 months after first device use
change in urinary control	The Expanded Prostate Cancer Index Composite (EPIC) urinary function assessment questionnaire will be administered. This is a 7 item tool assessing urinary function over the past 4 weeks. Higher scores indicate decreased urinary control	baseline to 12 months after first device use
change in urinary control	Mass of incontinence guards used over a 24 hour period in grams	baseline to 6 weeks after first device use
change in urinary control	Mass of incontinence guards used over a 24 hour period in grams	baseline to 3 months after first device use
change in urinary control	Mass of incontinence guards used over a 24 hour period in grams	baseline to 6 months after first device use
change in urinary control	Mass of incontinence guards used over a 24 hour period in grams	baseline to 9 months after first device use
change in urinary control	Mass of incontinence guards used over a 24 hour period in grams	baseline to 12 months after first device use
change in urinary control	The International Prostate Symptom Score (IPSS) Questionnaire will be administered. 7 questionnaires address urinary control with a total attainable score from 0-35. 0 = no dysfunction, 1-7 = mild dysfunction, 8 - 19 = moderate dysfunction, 20-35 = severe dysfunction. The 8th/final item addresses impact of urinary control on quality of life	baseline to 6 weeks after first device use
change in urinary control	The International Prostate Symptom Score (IPSS) Questionnaire will be administered. 7 questionnaires address urinary control with a total attainable score from 0-35. 0 = no dysfunction, 1-7 = mild dysfunction, 8 - 19 = moderate dysfunction, 20-35 = severe dysfunction. The 8th/final item addresses impact of urinary control on quality of life	baseline to 3 months after first device use
change in urinary control	The International Prostate Symptom Score (IPSS) Questionnaire will be administered. 7 questionnaires address urinary control with a total attainable score from 0-35. 0 = no dysfunction, 1-7 = mild dysfunction, 8 - 19 = moderate dysfunction, 20-35 = severe dysfunction. The 8th/final item addresses impact of urinary control on quality of life	baseline to 6 months after first device use
change in urinary control	The International Prostate Symptom Score (IPSS) Questionnaire will be administered. 7 questionnaires address urinary control with a total attainable score from 0-35. 0 = no dysfunction, 1-7 = mild dysfunction, 8 - 19 = moderate dysfunction, 20-35 = severe dysfunction. The 8th/final item addresses impact of urinary control on quality of life	baseline to 9 months after first device use
change in urinary control	The International Prostate Symptom Score (IPSS) Questionnaire will be administered. 7 questionnaires address urinary control with a total attainable score from 0-35. 0 = no dysfunction, 1-7 = mild dysfunction, 8 - 19 = moderate dysfunction, 20-35 = severe dysfunction. The 8th/final item addresses impact of urinary control on quality of life	baseline to 12 months after first device use

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
change in assessment of ease and acceptability of use of the Viberect	The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire will be administered. This is an 11 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	6 weeks after first device use to 3 months
change in assessment of ease and acceptability of use of the Viberect	The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire will be administered. This is an 11 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	6 weeks after first device use to 6 months
change in assessment of ease and acceptability of use of the Viberect	The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire will be administered. This is an 11 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	6 weeks after first device use to 9 months
change in assessment of ease and acceptability of use of the Viberect	The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire will be administered. This is an 11 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	6 weeks after first device use to 12 months
change in assessment of ease and acceptability of use of the Viberect	The Treatment Satisfaction Scale (TSS) questionnaire will be administered. This is an 21 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	baseline to 6 weeks after first device use
change in assessment of ease and acceptability of use of the Viberect	The Treatment Satisfaction Scale (TSS) questionnaire will be administered. This is an 21 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	baseline to 3 months after first device use
change in assessment of ease and acceptability of use of the Viberect	The Treatment Satisfaction Scale (TSS) questionnaire will be administered. This is an 21 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	baseline to 6 months after first device use
change in assessment of ease and acceptability of use of the Viberect	The Treatment Satisfaction Scale (TSS) questionnaire will be administered. This is an 21 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	baseline to 9 months after first device use
change in assessment of ease and acceptability of use of the Viberect	The Treatment Satisfaction Scale (TSS) questionnaire will be administered. This is an 21 item tool addressing participant satisfaction with the Viberect; higher scores indicate greater dissatisfaction	baseline to 12 months after first device use

Collaborators and Investigators

• Sponsor: Johns Hopkins University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2013
• Primary Completion (Actual): March 27, 2019
• Study Completion (Actual): March 27, 2019

Study Registration Dates

• First Submitted: October 24, 2012
• First Submitted That Met QC Criteria: October 28, 2012
• First Posted (Estimate): October 31, 2012

Study Record Updates

• Last Update Posted (Actual): May 24, 2019
• Last Update Submitted That Met QC Criteria: May 22, 2019
• Last Verified: May 1, 2019

More Information

Terms related to this study

• Keywords: rehabilitation; erectile dysfunction; incontinence
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Urologic Diseases; Lower Urinary Tract Symptoms; Urological Manifestations; Urination Disorders; Sexual Dysfunctions, Psychological; Sexual Dysfunction, Physiological; Elimination Disorders; Urinary Incontinence; Erectile Dysfunction; Enuresis
• Other Study ID Numbers: NA_00069795