- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06037356
PUL vs TURP in BPH Patients With Urinary Retention (PULTUR)
Prostatic Urethral Lift Versus Transurethral Resection of Prostate in Benign Prostatic Hyperplasia Patients With Urinary Retention
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study will be a prospective, non-inferiority randomized controlled trial with the aim of detecting a non-inferiority margin of 5%.
After the potential subject has been informed of the study and the potential risks, he will be screened for eligibility within a 4 week period. Assessment of eligibility will include questionnaires, blood tests, urine tests, uroflowmetry, flexible cystoscopy, transrectal ultrasound, and urodynamic study. Suitable subjects will then be randomized in a 1:1 ratio to the prostatic urethral lift (intervention group) and TURP (control group). Patients in the prostatic urethral lift will have the procedure performed under local anesthesia or monitored anesthetic care while TURP patients will be performed under spinal or general anesthesia. The subjects will have regular follow up 1 month, 3 months, 6 months, 1 year, 2 years, 3 years, 4 years, and 5 years post-operatively. Follow up assessments will include questionnaires, uroflowmetry, and occasional urodynamic study.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Brian SH Ho, MBBS
- Phone Number: (852)2255-3023
- Email: hobrian@hku.hk
Study Contact Backup
- Name: Stacia Chun, BSc(Hons)
- Phone Number: (852)2255-4852
- Email: stac@hku.hk
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male patients
- age >40 years old
- urinary retention who failed trial without catheter
Exclusion Criteria:
- Inability to provide consent OR no guardians or relatives to help provide consent on patient's behalf
- Active urinary tract infection
- Previous surgical treatment for benign prostatic hyperplasia (i.e., TURP, prostatic urethral lift, etc.)
- Bladder stones
- Urethral strictures or bladder neck contractures
- Prostate size >100mL
- Solely obstructing median lobe
- Urinary retention not due to obstruction (i.e., Bladder outflow obstruction index <20 on urodynamic studies)
- Poor detrusor contractility (maximum detrusor pressure <20cmH2O during voiding phase)
- Anticoagulant or antiplatelet agents that cannot be stopped
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Prostatic Urethral Lift
Prostatic urethral lift implants will be placed in patients under local anesthesia or monitored anesthetic care.
The number of implants used will depend on intra-operative findings, ranging from 2 to 8 implants per patient.
|
Prostatic urethral lift uses permanent implants to retract the prostate lobes away from the prostate urethra to allow unobstructed passage of urine.
These implants are made of Nitinol, non-absorbable monofilament suture material (Poly Ethylene Terephthalate), Stainless Steel
Other Names:
|
Active Comparator: TURP
Transurethral resection of prostate (TURP) will be performed under spinal or general anesthesia as per usual care.
|
Using monopolar or bipolar loop diathermy via cystoscopy, excess prostate tissue is resected piecemeal to remove obstruction to the prostatic urethra due to BPH
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Catheter-free rates after prostatic urethral lift versus TURP in BPH patients with urinary retention
Time Frame: 1 year after intervention
|
To determine how many patients will be catheter-free (defined as by the ability to void with a post-void residual urine <300mL) after intervention and remain catheter-free at 1 month, 3 months, and 1 year after intervention
|
1 year after intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compare complication rate of prostatic urethral lift versus TURP in BPH patients with urinary retention
Time Frame: 5 years
|
To determine the percentage and severity of complications after each intervention (according to the Clavien-Dindo classification)
|
5 years
|
Cost effectiveness of prostatic urethral lift versus TURP in achieving catheter-free rates in BPH patients with urinary retention
Time Frame: 1 year
|
To determine the cost required to achieve catheter free patients for each intervention (including hospitalization, anesthetic costs, equipment, consumables, etc)
|
1 year
|
Compare patient satisfaction by PGI-I questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the Patient global impression of improvement (PGI-I) questionnaire to determine patient satisfaction after each intervention.
|
1 year
|
Compare patient reported symptom measures by IPSS questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using International prostate symptom score (IPSS) questionnaire to determine patient reported symptom measure after each intervention
|
1 year
|
Compare patient reported symptom measures by ISI questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the Incontinence severity index (ISI) questionnaire to determine patient reported symptom measure after each intervention
|
1 year
|
Compare patient reported symptom measures by IIEF-5 questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the International index of erectile function- 5 items (IIEF-5) questionnaire to determine patient reported symptom measure after each intervention
|
1 year
|
Compare patient reported symptom measures by MSHQ-EjD short form questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) short form questionnaire to determine patient reported symptom measure after each intervention.
|
1 year
|
Compare patient reported quality of life by SF-12 questionnaire after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the Short Form 12 (SF-12) questionnaire to determine patient reported quality of life measures after each intervention
|
1 year
|
Compare patient reported quality of life by derived SF-6D utility score after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the derived Short Form 6 Dimension (SF-6D) utility score questionnaire to determine patient reported quality of life measures after each intervention
|
1 year
|
Compare patient reported recovery by VAS after prostatic urethral lift versus TURP
Time Frame: 1 year
|
Using the Visual analogue scale of quality of recovery to determine patient reported recovery after each intervention
|
1 year
|
Compare improvement bladder contractility index after prostatic urethral lift versus TURP
Time Frame: 5 year
|
Pre- and post-intervention urodynamic will be performed to assess bladder contractility index as well as subsequent improvement and durability of above stated urodynamic parameter after each intervention
|
5 year
|
Compare improvement of Bladder outflow obstruction index after prostatic urethral lift versus TURP
Time Frame: 5 year
|
Pre- and post-intervention urodynamic will be performed to assess bladder outflow obstruction index (BOOI) as well as subsequent improvement and durability of above stated urodynamic parameter after each intervention
|
5 year
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Brian SH Ho, MBBS, Queen Mary Hospital, Hong Kong
Publications and helpful links
General Publications
- Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991 Aug 24;338(8765):469-71. doi: 10.1016/0140-6736(91)90543-x.
- Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA, Lieber MM. Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status. J Urol. 1999 Oct;162(4):1301-6.
- Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999 Feb;83(3):227-37. doi: 10.1046/j.1464-410x.1999.00908.x. No abstract available.
- Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and postoperative complications. a cooperative study of 13 participating institutions evaluating 3,885 patients. 1989. J Urol. 2002 Feb;167(2 Pt 2):999-1003; discussion 1004. No abstract available.
- Neal DE. The National Prostatectomy Audit. Br J Urol. 1997 Apr;79 Suppl 2:69-75. doi: 10.1111/j.1464-410x.1997.tb16924.x. No abstract available.
- Woo HH, Chin PT, McNicholas TA, Gill HS, Plante MK, Bruskewitz RC, Roehrborn CG. Safety and feasibility of the prostatic urethral lift: a novel, minimally invasive treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BJU Int. 2011 Jul;108(1):82-8. doi: 10.1111/j.1464-410X.2011.10342.x. Epub 2011 May 6.
- Walsh LP. State of the art: Advanced techniques for prostatic urethral lift for the relief of prostate obstruction under local anesthesia. Can J Urol. 2017 Jun;24(3):8859-8864.
- Eure G, Gange S, Walter P, Khan A, Chabert C, Mueller T, Cozzi P, Patel M, Freedman S, Chin P, Ochs S, Hirsh A, Trotter M, Grier D. Real-World Evidence of Prostatic Urethral Lift Confirms Pivotal Clinical Study Results: 2-Year Outcomes of a Retrospective Multicenter Study. J Endourol. 2019 Jul;33(7):576-584. doi: 10.1089/end.2019.0167. Epub 2019 Jun 25.
- Roehrborn CG, Barkin J, Gange SN, Shore ND, Giddens JL, Bolton DM, Cowan BE, Cantwell AL, McVary KT, Te AE, Gholami SS, Moseley WG, Chin PT, Dowling WT, Freedman SJ, Incze PF, Coffield KS, Herron S, Rashid P, Rukstalis DB. Five year results of the prospective randomized controlled prostatic urethral L.I.F.T. study. Can J Urol. 2017 Jun;24(3):8802-8813.
- McVary KT, Gange SN, Shore ND, Bolton DM, Cowan BE, Brown BT, Te AE, Chin PT, Rukstalis DB, Roehrborn CG; L.I.F.T. Study Investigators. Treatment of LUTS secondary to BPH while preserving sexual function: randomized controlled study of prostatic urethral lift. J Sex Med. 2014 Jan;11(1):279-87. doi: 10.1111/jsm.12333. Epub 2013 Sep 30.
- Sievert KD, Schonthaler M, Berges R, Toomey P, Drager D, Herlemann A, Miller F, Wetterauer U, Volkmer B, Gratzke C, Amend B. Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years. World J Urol. 2019 Jul;37(7):1353-1360. doi: 10.1007/s00345-018-2494-1. Epub 2018 Oct 3.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- QMH PULTUR Study
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
product manufactured in and exported from the U.S.
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 BPH With Urinary Obstruction
-
Boston Scientific CorporationTerminatedBPH | BPH With Urinary Obstruction | BPH With Urinary Obstruction With Other Lower Urinary Tract SymptomsUnited States, Australia
-
Mansoura UniversityRecruiting
-
Benaroya Research InstituteVirginia Mason Hospital/Medical CenterUnknownPain | BPH With Urinary Obstruction | BPH With Urinary Obstruction With Other Lower Urinary Tract SymptomsUnited States
-
BE Technologies IncUrology of VirginiaCompletedOveractive Bladder | Lower Urinary Tract Symptoms | Urinary Incontinence, Urge | Overactive Bladder Syndrome | BPH | Urinary Obstruction | BPH With Urinary Obstruction With Other Lower Urinary Tract Symptoms | BPH Without Urinary Obstruction | BPH Without Urinary Obstruction With Other Lower Urinary...United States
-
Cairo UniversityTheodor Bilharz Research InstituteCompletedMale | BPH With Urinary ObstructionEgypt
-
Cairo UniversityCompletedMale | BPH With Urinary ObstructionEgypt
-
Cairo UniversityTheodor Bilharz Research InstituteCompletedMale | BPH With Urinary ObstructionEgypt
-
San Carlo di Nancy HospitalLampugnani Farmaceutici S.p.A. (Nerviano, Milan, Italy)CompletedBPH With Urinary Obstruction With Other Lower Urinary Tract SymptomsItaly
-
Mansoura UniversityUnknownProstatic Hyperplasia | Prostate Disease | BPH With Urinary Obstruction | Prostate Obstruction | Ejaculation AbnormalEgypt
-
Salem Hassan Salem MohamedCompletedBPH With Urinary ObstructionEgypt
Clinical Trials on Prostatic Urethral Lift
-
Case Comprehensive Cancer CenterWithdrawnProstate Cancer | Benign Prostatic Hyperplasia (BPH)
-
University Hospital, BordeauxBordeaux PharmacoEpiRecruiting
-
St. Louis UniversityWithdrawnLower Urinary Tract Symptoms | Benign Prostatic Hyperplasia | Urinary Incontinence, Urge | Nocturia | Incontinence, Urinary | Urinary Frequency/UrgencyUnited States
-
University College Hospital GalwayCompleted
-
Zhen Jun WangPeking University Third Hospital; Shaanxi Provincial People's Hospital; Tianjin... and other collaboratorsUnknownAnorectal Fistula | Extracellular Matrix AlterationChina
-
Massachusetts General HospitalWithdrawnUrinary Catheter-Related DiscomfortUnited States
-
Mansoura UniversityActive, not recruitingPartial Edentulism Class 2 Due to Periodontal DiseaseEgypt
-
ProVerum MedicalRecruitingBenign Prostatic Hyperplasia With Symptomatic Lower Urinary Tract SymptomsUnited States, Canada, Ireland
-
Assaf-Harofeh Medical CenterUnknown
-
University of FloridaActive, not recruitingBiomechanics | Limb Length DiscrepancyUnited States