The Zenflow Spring System EU Safety and Performance Study (ZEST EU)

The objectives of the trial are to demonstrate the safety and performance of the Zenflow Spring System in relieving the symptoms of obstructive Benign Prostatic Hyperplasia (BPH).

Study Overview

• Status: Recruiting
• Conditions: Benign Prostatic Hyperplasia
• Intervention / Treatment: Device: Zenflow Spring System

Detailed Description

A multi-center, prospective, single arm safety and performance trial. Subjects will be treated either in the Investigator's out-patient treatment room or in the OR, with local anaesthesia only. All subjects will be followed for the entire duration of the study until exit after the 60 month follow-up visit.

• Study Type: Interventional
• Enrollment (Anticipated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Debra Cogan, B.A., RN; Phone Number: +001 408 515-0820; Email: dcogan@zenflow.com
• Study Contact Backup: Name: Nicholas Damiano, MS; Phone Number: +001 650 642-9658; Email: Nick@zenflow.com

Study Locations

• Australia
  • New South Wales
    • Wahroonga, New South Wales, Australia, 2076
      • Not yet recruiting
      • Australian Clinical Trials
    • Wollongong, New South Wales, Australia, 2500
      • Recruiting
      • South Coast Urology
      • Contact: Julie Edwards; Phone Number: +61 612 4271 6644; Email: nurse@southcoasturology.com.au
  • Victoria
    • Bendigo, Victoria, Australia, 3550
      • Recruiting
      • Goldfields Urology
      • Contact: Janelle Brennan, Miss, MD; Phone Number: +61354413130
      • Contact: Janet Bennett, CRA; Phone Number: +61354413130; Email: janet_bennett@goldfieldsurology.com.au
    • Melbourne, Victoria, Australia, 3050
      • Recruiting
      • Royal Melbourne Hospital
      • Contact: Richard Verrelli; Phone Number: +61 613 9342 7348; Email: richard.verrelli@mh.org.au
      • Principal Investigator: Paul Anderson, MD
• New Zealand
  • Tauranga, New Zealand, 3140
    • Recruiting
    • Urology Bay of Plenty
    • Contact: Rana Reuther, CRA; Phone Number: 64 7 577 7795; Email: rana@urobop.co.nz
    • Contact: Peter Gilling, MD; Phone Number: 64 7 579 0466; Email: peter@urobop.co.nz

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

1. Patient is able and willing to comply with all the assessments of the study
2. Patient or patient's legal representative has been informed of the nature of the study, agrees to participate and has signed the informed consent form
3. ≥ 45 years of age
4. Baseline IPSS score > 13, and a baseline Quality of Life (QoL) question score > 3
5. Prostate volume 25 - 80 cc by Trans Rectal Ultrasound (TRUS) or abdominal ultrasound, measured within past 90 days and prostatic urethral length between 2.5- 4.5 cm
6. Failed, intolerant, or patient choice to not take a medication regimen for the treatment of LUTS

7. Patient must meet ONE of the following criteria:

   1. Baseline PSA <= 2.5ng/mL
   2. Baseline PSA >2.5 ng/mL and <=10 ng/mL AND free PSA >=25% of total PSA (no biopsy required or negative biopsy)
   3. Baseline PSA >10ng/mL AND negative prostate biopsy1 result within 12 months
   4. Negative prostate biopsy1 within 12 months if abnormal digital rectal examination
   5. 3 Tesla MRI of the prostate, with normal findings, within 12 months prior to the baseline visit

Exclusion Criteria:

1. Obstructive intravesical median prostatic lobe which, in the opinion of the Investigator, would not benefit from treatment
2. Urethral stricture, meatal stenosis, or bladder neck obstruction - either current, or recurrent requiring 2 or more dilations as reported in the patient's history
3. Requiring self-catheterization to void
4. Baseline PSA > 10 ng/mL or confirmed or suspected prostate cancer

5. Any of the following, taken from a single uroflowmetry reading:

   1. Peak urinary flow rate > 12 ml/second
   2. Post-void residual (PVR) > 250 ml
   3. Peak Urinary flow rate of > 15 ml/second
   4. < 125ml urinary volume voided at baseline (pre-bladder urinary volume of ≥ 150 ml required)
6. Other condition or disease that might cause urinary retention
7. History of other diseases causing voiding dysfunction
8. Concomitant Urinary Tract Infection (UTI) (subject can be enrolled following successful treatment of UTI and a clean urine test), or a history of recurrent or chronic UTIs (defined as 2 or more UTIs in the past 12 months)
9. Concomitant bladder stones
10. Previous pelvic irradiation or radical pelvic surgery
11. Previous prostate surgery, stent implantations, laser prostatectomy, hyperthermia or another invasive treatment to the prostate
12. Chronic prostatitis, or recurring prostatitis within the past 12 months
13. Known allergy to nickel
14. Life expectancy less than 24 months
15. Use of concomitant medications (e.g., anticholinergics, antispasmodics or antidepressants) affecting bladder function
16. Inability to stop taking anticoagulants and/or antiplatelets for at least 3 days prior to the procedure or coumadin for at least 5 days prior to the procedure (low dose aspirin therapy not prohibited)
17. Taking 5-alpha reductase inhibitors within 3 months of pre-treatment (baseline) evaluation unless evidence of same drug dose for at least 6 months with a stable voiding pattern (the drug dose should not be altered or discontinued throughout the study)

18. Taking one of the following within 2 weeks of pre-treatment (baseline) evaluation:

    1. alpha-blockers,
    2. androgens,
    3. anticholinergics, or
    4. cholinergic medication gonadotropin releasing hormonal analogs

19. Taking one of the following within 24 hours of pre-treatment (baseline) evaluation:

    1. phenylephrine, or
    2. pseudoephedrine
20. Future fertility concerns
21. Any severe illness that might prevent study completion or would confound study results

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Zenflow Spring System; Receives treatment with the investigational device	Device: Zenflow Spring System; The Zenflow Spring System consists of the Spring Delivery System with Implant, Spring Scope, Camera Control Unit (CCU), Measurement Tool, and Spring Retrieval Tool.; Other Names: Spring Implant

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Successful placement of the Zenflow Spring Implant	Successful deployment and procedural success for the Zenflow System to implant the Spring device in the operating room or an out-patient clinical setting.	Day of discharge up to 7 days following device placement
Need for urinary catheterization	Rate of extended post-operative urinary catheterization	7 days after the procedure
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH) using the International Prostate Symptom Score and Quality of Life Score (IPSS+QoL)	The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score. In addition the patient is asked 1 question related to his Quality of Life. The possible responses range from 0 to 6 where 0 is the best and 6 is the worst.	Baseline and 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of Adverse Events	Rate of adverse events related to the procedure or device.	Up to 2 years
Incidence of procedure or device related serious adverse events	Assessment of any device or procedure related Serious Adverse Events (SAE)	Up to 30 days
Assessment of Sexual Health Assessment: Change in sexual health measured by change in the Sexual Health Inventory for Men (SHIM) questionnaire score	The patient selects the most appropriate response to 5 questions about his sexual health. Each response has an assigned value between 1 and 5. The numeric values are tallied for a total score.	Baseline, 3, 6, 12, & 24 months
Assessment of Sexual Health Assessment: Change in sexual health measured by change in ability to ejaculate using the Male Sexual Health Questionnaire - Ejaculatory domain (MSHQ-EjD)	The patient selects the most appropriate response to 4 questions about his sexual health specific to ejaculation. Each response has an assigned value between 0 and 5.	Baseline, 3, 6, 12, & 24 months
Assessment of Pain, evaluated using a Visual Analog Score (VAS) of 1 to 10	Patient describes pain on a Visual Analog Scale (VAS). The scale is a line labeled 1 at the far left indicating minimal pain and 10 on the right, which is maximum pain.	Baseline, 2 weeks, 1 month and 3 months
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)	The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score. In addition the patient is asked 1 question related to his Quality of Life. The possible responses range from 0 to 6 where 0 is the best and 6 is the worst.	Baseline, 2 weeks, 1, 6, 12, 24 months
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)	Improvement in flow of urine as measured by uroflowmetry machine.	Baseline, 2 weeks, 1, 3, 6, 12, 24 months
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)	Incidence of repeat invasive treatment for Lower Urinary Tract Symptoms (LUTS) or increase in dosage or initiation of new medication to treat symptoms of BPH.	Up to 2 years

Collaborators and Investigators

• Sponsor: Zenflow, Inc.

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 16, 2019
• Primary Completion (ANTICIPATED): December 1, 2022
• Study Completion (ANTICIPATED): May 30, 2024

Study Registration Dates

• First Submitted: May 16, 2018
• First Submitted That Met QC Criteria: July 2, 2018
• First Posted (ACTUAL): July 5, 2018

Study Record Updates

• Last Update Posted (ACTUAL): July 22, 2021
• Last Update Submitted That Met QC Criteria: July 15, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Prostatic Diseases; Prostatic Hyperplasia; Hyperplasia
• Other Study ID Numbers: CLIN-0050

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No