- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT05762198
Et randomiseret kontrolleret forsøg, der sammenligner termisk vanddampterapi (Rezūm) og TURP
Et randomiseret kontrolleret forsøg, der sammenligner vanddamptermisk terapi (Rezūm) og TURP hos mænd med godartet prostatahyperplasi i refraktær urinretention
This is a randomized controlled trial using a non-inferiority design with the subjects randomized 1:1 to either water vapour thermal treatment (REZUM) arm or transurethral resection of prostate (TURP) arm.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
-
Hong Kong, Hong Kong
- Prince of Wales Hospital, Chinese University of Hong Kong
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Men 50-80 years
- Refractory urinary retention related to benign prostatic hyperplasia (BPH)
- On urethral Foley's catheter or clean intermittent self-catheterization (CISC) before treatment
- Prostate size 30-80ml on ultrasound
Exclusion Criteria:
- Prior prostate operation
- Past or current history of prostate cancer
- Strong suspicion of prostate cancer (e.g. Elevated PSA before urinary retention or abnormal prostate on DRE without workup for prostate cancer)
- Known Urethral stricture / Bladder stone / Hypocontractile bladder
- Known neurological diseases which may affect bladder function (e.g. Parkinsonism, stroke)
- Contraindicated to undergo TURP or REZUM (e.g. not fit for GA/SA, active urinary tract infection, fail to be placed in lithotomy position, uncorrectable coagulopathy, antiplatelet or anticoagulant which cannot be stopped)
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: Rezūm
|
In the REZUM arm, water vapour treatment is performed for all subjects under local anaesthesia. |
|
Aktiv komparator: TURP
|
In the TURP arm, all men will receive TURP operation under general or spinal anaesthesia |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
International Prostate Symptom Score (IPSS) at 12 months after treatment
Tidsramme: 3 months, 6 months and 12 months after intervention
|
IPSS score ranging from 0-35 (the higher the worse) |
3 months, 6 months and 12 months after intervention
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Successful trial without catheter (TWOC) within 3 months
Tidsramme: At 3 months
|
Percentage of patients successfully TWOC |
At 3 months
|
|
Complication rate
Tidsramme: 30 days after intervention
|
Assessed by Clavien-Dindo classification |
30 days after intervention
|
|
Post-op quality of life score
Tidsramme: 3 months, 6 months and 12 months after intervention
|
Change in quality of life assessed by change in International Prostate QOL score (ranges from 0 to 6, the higher the worse) |
3 months, 6 months and 12 months after intervention
|
|
Change in voiding function in uroflowmetry
Tidsramme: 3 months, 6 months and 12 months after intervention
|
It is assessed by maximum flow rate and post void volume in uroflowmetry |
3 months, 6 months and 12 months after intervention
|
|
Post-op Erectile Function Domain of the International Index of Erectile Function score
Tidsramme: 3 months, 6 months and 12 months after intervention
|
Score 1-5 (the lower the worse) |
3 months, 6 months and 12 months after intervention
|
|
Hospital stays of procedure
Tidsramme: During hospitalization, assessed at discharge
|
Measure the hours of in-patient hospitalisation |
During hospitalization, assessed at discharge
|
|
Unplanned readmission rate after operation in 30 days
Tidsramme: 30 days after intervention
|
Percentage of patients with unplanned readmission |
30 days after intervention
|
|
Bladder outlet obstruction index (BOOI) by Urodynamic studies
Tidsramme: Performed at 12 months after treatment
|
Performed at 12 months after treatment
|
|
|
Bladder contractility index (BCI) by Urodynamic studies
Tidsramme: Performed at 12 months after treatment
|
Performed at 12 months after treatment
|
Samarbejdspartnere og efterforskere
Sponsor
Efterforskere
- Ledende efterforsker: Peter Ka-Fung CHIU, FRCS, PhD, Chinese University of Hong Kong
Publikationer og nyttige links
Generelle publikationer
- McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, Rousseau M, Beahrs JR, Kaminetsky J, Cowan BE, Cantrill CH, Mynderse LA, Ulchaker JC, Larson TR, Dixon CM, Roehrborn CG. Minimally Invasive Prostate Convective Water Vapor Energy Ablation: A Multicenter, Randomized, Controlled Study for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2016 May;195(5):1529-1538. doi: 10.1016/j.juro.2015.10.181. Epub 2015 Nov 22.
- Cantrill CH, Zorn KC, Elterman DS, Gonzalez RR. The Rezum system - a minimally invasive water vapor thermal therapy for obstructive benign prostatic hyperplasia. Can J Urol. 2019 Jun;26(3):9787-9793.
- Barry MJ, Williford WO, Chang Y, Machi M, Jones KM, Walker-Corkery E, Lepor H. Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients? J Urol. 1995 Nov;154(5):1770-4. doi: 10.1016/s0022-5347(01)66780-6.
- Ng CF, Yee CH, Chan CK, Wong HM, Chiu PK, Tsu JH, Teoh JY, Ho KL. Bipolar transurethral vapourisation versus monopolar transurethral resection of prostate: a randomised controlled trial. Hong Kong Med J. 2017 Jun;23 Suppl 2(3):32-34. No abstract available.
- Yee CH, Wong JH, Chiu PK, Chan CK, Lee WM, Tsu JH, Teoh JY, Ng CF. Short-stay transurethral prostate surgery: A randomized controlled trial comparing transurethral resection in saline bipolar transurethral vaporization of the prostate with monopolar transurethral resection. Asian J Endosc Surg. 2015 Aug;8(3):316-22. doi: 10.1111/ases.12197. Epub 2015 Jun 3.
- McVary KT, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, Pliskin M, Beahrs JR, Prall D, Kaminetsky J, Cowan BE, Cantrill CH, Mynderse LA, Ulchaker JC, Tadros NN, Gange SN, Roehrborn CG. Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia. J Urol. 2021 Sep;206(3):715-724. doi: 10.1097/JU.0000000000001778. Epub 2021 Apr 19.
- Yee CH, Wong JH, Chiu PK, Teoh JY, Chan CK, Chan ES, Hou SM, Ng CF. Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate. Urol Ann. 2016 Oct-Dec;8(4):458-463. doi: 10.4103/0974-7796.192110.
- Yip SK, Chan NH, Chiu P, Lee KW, Ng CF. A randomized controlled trial comparing the efficacy of hybrid bipolar transurethral vaporization and resection of the prostate with bipolar transurethral resection of the prostate. J Endourol. 2011 Dec;25(12):1889-94. doi: 10.1089/end.2011.0269. Epub 2011 Sep 16.
- Teo JS, Lee YM, Ho HSS. An update on transurethral surgery for benign prostatic obstruction. Asian J Urol. 2017 Jul;4(3):195-198. doi: 10.1016/j.ajur.2017.06.006. Epub 2017 Jun 15.
- McVary KT, El-Arabi A, Roehrborn C. Preservation of Sexual Function 5 Years After Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia. Sex Med. 2021 Dec;9(6):100454. doi: 10.1016/j.esxm.2021.100454. Epub 2021 Oct 30.
- McVary KT, Holland B, Beahrs JR. Water vapor thermal therapy to alleviate catheter-dependent urinary retention secondary to benign prostatic hyperplasia. Prostate Cancer Prostatic Dis. 2020 Jun;23(2):303-308. doi: 10.1038/s41391-019-0187-5. Epub 2019 Nov 18.
- Ray AF, Powell J, Speakman MJ, Longford NT, DasGupta R, Bryant T, Modi S, Dyer J, Harris M, Carolan-Rees G, Hacking N. Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the UK-ROPE study). BJU Int. 2018 Aug;122(2):270-282. doi: 10.1111/bju.14249. Epub 2018 May 6.
- Yu SCH, Cho C, Hung E, Wang D, Chiu P, Yee CH, Ng A. Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic Artery Embolization for Benign Prostatic Hypertrophy. J Vasc Interv Radiol. 2017 Aug;28(8):1167-1176. doi: 10.1016/j.jvir.2017.04.004. Epub 2017 May 13.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Genitale sygdomme
- Kønssygdomme, mandlige
- Prostatasygdomme
- Mandlige urogenitale sygdomme
- Prostatahyperplasi
- Kirurgiske procedurer, operative
- Urologiske kirurgiske procedurer
- Urogenitale kirurgiske procedurer
- Urologiske kirurgiske procedurer, mandlige
- Prostatektomi
- Transuretral resektion af prostata
Andre undersøgelses-id-numre
- CRE-2022.537-T
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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