- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03181243
The Acceptance, Safety, and Efficacy of MadaJet Versus Needle Injection for Sperm Retrieval in Patients With Azoospermia
The Acceptance, Safety, and Efficacy of Needle-free Jet Anaesthetic Technique (MadaJet) Versus Needle Injection for Sperm Retrieval in Patients With Azoospermia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Azoospermia is found in 1-3% of general population and 10-15% of men presenting with infertility. In this scenario, there are no spermatozoa in the patient's semen after centrifugation, and pregnancy may be achieved through IVF/ Intracytoplasmic sperm injection (ICSI) combined with sperm retrieval techniques (e.g. PESA, testicular sperm extraction - TESE, TESA). These techniques are commonly conducted under local anesthesia, which a 10-15 mL solution of 2% lidocaine hydrochloride injected around the spermatic cord near the external inguinal ring. However, needle fear is prevalent in both children (~33-63%) and adults (~14-38%) and can contribute to negative experiences with needle procedures and health care for patients, caregivers, and health professionals. In clinical practice, patients often concern about the pain, trauma and possible complication (i.e. wheal, hematoma, infection) of needle injection of local anaesthesia into and through the scrotal wall when performing sperm retrieval. It not only interferes with clinicians' abilities to carry out procedures (e.g. due to flailing and attempts to escape), but also undermines the efficacy of pain interventions at the time of the needle. Therefore, receiving local anaesthesia without a needle is easily well accepted by the patients with azoospermia.
The needleless jet injector (MadaJet Medical Injector) has been widely used in the fields of dermatology, cosmetic and plastic surgery, gynecology, dentistry, and podiatry as well as for immunization. It was also employed for no-scalpel vasectomy in Urology/Andrology. The first studies using needleless jet injector for spermatic cord block was reported by Wilson in 2001 and Weiss in 2005. The next studies showed that MadaJet has better outcomes (e.g. cost, pain scores, onset time) than traditional needle anaesthesia (16-18). Unlike a conventional spermatic cord block with needle injection, there is no wheal on the patients' skin and local edema after administering injection. A mist of solution with a high-pressure injector will be rapidly delivered and absorbed through the skin to the tissue beneath around the cord with much less trauma. As a consequence, it is less painful than the needle injection.
For those reasons, a needle-free jet anaesthetic technique for sperm retrieval will be described for local anaesthesia, which may minimize the fear of the needle. The acceptance, safety, and efficacy of this technique will also be compared with needle injection for sperm retrieval in azoospermia patients.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ho Chi Minh City, Vietnam, 84
- My Duc Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients (including obstructive azoospermia and non-obstructive azoospermia) in need of sperm retrieval (PESA, TESE) for ICSI.
Exclusion Criteria:
- Have not finished the process of sperm retrieval techniques.
- Malformation of genital organs (e.g. spermatic cord, testicle)
- Anxious, alcoholic patients.
- Patients giving a history of personality disorders.
- Patients who abuse drugs.
- Disagree to participate in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: MadaJet
Jet injector (Madajet medical Urology) preloaded as manufacturer's instruction
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The spermatic cord is firmly trapped between the middle finger, index finger and thumb of the left hand.
The injector's sheath is placed over the spermatic cord with gentle pressure adjacent to the external inguinal ring.
Depending upon the thickness of spermatic cord, three or four injections are consecutively administered around it, beginning from proximal to distal points.
Other Names:
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Experimental: Needle injection
01 sterile 10-mL syringe with small gauge needle (25 ga), solution for sterile preparation, 10 - 15 mL Lidocaine 2%
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The pubic tubercle is palpated on the side that is going to be blocked.
The spermatic cord is then immobilised with the non-dominant hand between the thumb and index finger.
Right after needle puncture with attached syringe and local anaesthetic solution is conducted at a point that is 1 cm inferior to and 1 cm medial to the pubic tubercle, pass the needle directly downward in a vertical fashion, which leads it into the spermatic cord.
After a check-up (negative aspiration) for bleeding, approximately 3 mL of solution (Lidocaine 2%) is injected into the cord.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain score
Time Frame: 1 year
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Right after completing the injection, information about the pain before, during and after the sperm retrieval technique will be immediately documented by the visual analog scale (VAS) questionnaire on 10 cm lines (0 represents no pain, whereas 10 marks the highest score).
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1 year
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pressure (fear) of the patients
Time Frame: 1 year
|
Right after completing the injection, information about the pain before, during and after the sperm retrieval technique will be immediately documented by the visual analog scale (VAS) questionnaire on 10 cm lines (0 represents no pain, whereas 10 marks the highest score).
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1 year
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Discomfort of the patients
Time Frame: 1 year
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Right after completing the injection, information about the pain before, during and after the sperm retrieval technique will be immediately documented by the visual analog scale (VAS) questionnaire on 10 cm lines (0 represents no pain, whereas 10 marks the highest score).
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1 year
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Incidence of treatment (Bleeding)
Time Frame: 1 year
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Bleeding will be recorded peri- and post- operative anesthesia.
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1 year
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Incidence of treatment (Swelling)
Time Frame: 1 year
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Swelling will be recorded peri- and post- operative anesthesia.
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1 year
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Incidence of treatment (Hematoma)
Time Frame: 1 year
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Hematoma will be recorded peri- and post- operative anesthesia.
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1 year
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Onset of action of Madajet
Time Frame: 1 year
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By using the stopwatch, the onset of action of anesthesia will be recorded.
Every five seconds, the pain reaction which shows the onset is determined on the scrotum by using tissue forceps.
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1 year
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Duration of action of Madajet
Time Frame: 1 year
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By using the stopwatch, the duration of action of anesthesia will be recorded.
The patients are observed in the operation room until all the symptoms of anesthesia wore off.
The total duration of anesthesia is measured from the time of onset until the patient reports normal reaction in the scrotum.
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1 year
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Onset of action of Needle injection
Time Frame: 1 year
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By using the stopwatch, the onset of action of anesthesia will be recorded.
Every thirty seconds, the pain reaction which shows the onset is determined on the scrotum by using tissue forceps.
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1 year
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Duration of action of Needle injection
Time Frame: 1 year
|
By using the stopwatch, the duration of action of anesthesia will be recorded.
The patients are observed in the operation room until all the symptoms of anesthesia wore off.
The total duration of anesthesia is measured from the time of onset until the patient reports normal reaction in the scrotum.
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1 year
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Khoa D Le, Dr, Mỹ Đức Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NCKH/CGRH_03_2017
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
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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