- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03991455
Evaluation of Safety and Efficacy of the Apyx™ Device for the Repair of Pelvic Organ Prolapse (POP)
July 26, 2022 updated by: Escala Medical LTD
The aim of this study is to further evaluate this minimally invasive SSLF technique with respect to safety, clinical effectiveness, and patient satisfaction.
The procedure will be performed in women electing to undergo surgical repair of their prolapse who wish to preserve their uterus, and will be evaluated using standardized measures and questionnaires.
Study Overview
Detailed Description
This study will evaluate sacrospinous ligament fixation using an incision-free technique - a technique that was developed with the goal of offering a technically simple, safe, and effective alternative to surgical prolapse repair procedures.
When compared to previously reported SSLF methods, this technique has undergone novel modifications with the intent of maximizing efficacy and minimizing invasiveness.
First, each sacrospinous ligament is approached trans-vaginally using a small diameter, low profile needle as the delivery platform for the anchoring unit.
Secondly, the suspension is bilateral, thus maintaining vaginal length and width without deviation or narrowing of the vagina as might occur with a traditional (unilateral) sacrospinous repair.
And third, using bio-degradable sutures and a securing element that stabilizes the fixation as opposed to performing an incision in the vaginal wall for suturing enables an incision-free procedure leaving the vagina free of any device after a period of several weeks.
Study Type
Interventional
Enrollment (Actual)
17
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
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Haifa, Israel, 3109601
- Rambam Medical Center
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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
18 years to 90 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
Women with prolapse electing to undergo reconstructive vaginal surgery for primary uterovaginal prolapse, who wish to enroll in this trial of an incision-free prolapse repair technique, after being familiarized with the suspected benefits and risks of the procedure.
- Ages 18-90 years old
- POP-Q Stage 2 or greater with an apical support defect, also defined as uterovaginal prolapse
- Desire of uterine preservation
- Patient is willing to return for follow-up evaluation and questionnaire completion at 3 months, 6 months, and 12 months, in addition to routine postoperative standard of care.
- English fluency
Exclusion Criteria:
- Previous vaginal, abdominal, or laparoscopic repair for pelvic organ prolapse
- Prior hysterectomy
- Known allergy to Nitinol / Stainless Steel / Polydioxanone.
- Suspected uterine pathology, including malignancy.
- History of chronic pelvic pain, interstitial cystitis or fibromyalgia.
- Women diagnosed with symptomatic uterine fibroids, cervical elongation or hypertrophy, abnormal uterine or vaginal bleeding.
- History of Pelvic Inflammatory Disease (PID)
- Prior pelvic radiation therapy or malignancy.
- Diagnosis of reproductive tract anomalies.
- Pregnant or lactating women.
- Participation in another trial
- Inability to provide informed consent for study enrollment
- PI's subjective assessment that study procedure will not plausibly correct patient pelvic organ prolapse symptoms due to anatomic considerations
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: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Other: Apyx device treatment
The Apyx device enables approximation and fixation of the vaginal apex to the SSL using a deployable anchoring system.
Using the device, SSLF can be performed transvaginally without the need for any incisions or blind dissections and without the requirement of heavy anesthesia.
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The Apyx device enables approximation and fixation of the vaginal apex to the SSL using a deployable anchoring system.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in PFDI-20 Prolapse Subscale (POPDI-6) score
Time Frame: 6 months
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Pelvic Floor Disability Index (PFDI-20) includes 20 questions are rated from 0 to 4, with 0 is no present of distress and 4 is the highest of symptom scale.
Pelvic Floor Disability Index distress index is a subscale of the first 6 questions of the above scale
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Objective success rate
Time Frame: 6 months
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POP-Q points Ba less than -1 and C less than -½ TVL
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6 months
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Change in PFDI-20
Time Frame: at baseline 3 months, 6 months, and 12 months compared to preoperative
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Pelvic Floor Disability Index (PFDI-20) includes 20 questions are rated from 0 to 4, with 0 is no present of distress and 4 is the highest of symptom scale
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at baseline 3 months, 6 months, and 12 months compared to preoperative
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Change in PISQ-12 scores
Time Frame: at baseline 3 months, 6 months, and 12 months compared to preoperative
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The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire -12 (PISQ-12) includes question for estimation of sexual function for women with POP urinary incontinence and or fecal incontinence
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at baseline 3 months, 6 months, and 12 months compared to preoperative
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PGI-I
Time Frame: 3 months, 6 months, and 12 months
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Patient Global Impression of Improvement include one question which describes how the patient evaluates the post surgery improvement with a scale of 1 to 7. 1 is very much better and 7 is very much worse
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3 months, 6 months, and 12 months
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Unanticipated Device-related Serious Adverse Event rate
Time Frame: at intervals of 2 weeks, 3 months, 6 months, and 12 months
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Unanticipated Device-related Serious Adverse Event rate
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at intervals of 2 weeks, 3 months, 6 months, and 12 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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 (Actual)
October 25, 2019
Primary Completion (Actual)
May 1, 2022
Study Completion (Actual)
May 1, 2022
Study Registration Dates
First Submitted
June 17, 2019
First Submitted That Met QC Criteria
June 18, 2019
First Posted (Actual)
June 19, 2019
Study Record Updates
Last Update Posted (Actual)
July 27, 2022
Last Update Submitted That Met QC Criteria
July 26, 2022
Last Verified
July 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1806019328
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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