- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT01130870
Dose Response Curve - Sacral Nerve Stimulation for Faecal Incontinence
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Faecal incontinence is a devastating condition with huge impact on quality of life. Sacral Nerve Stimulation (SNS) has since 1995 been a treatment option for patients not obtaining satisfactory continence result with standard non-surgical treatments. SNS is electrical stimulation of the sacral nerve root(s2,3 or 4). Stimulation of this nerve roots results in improved continence. The mechanism of action is at present not well described.
Standard the neuromodulator (pacemaker) stimulate with Frequency 14 Hz, pulse width 210 mic.sec. and amplitude set at sensory threshold. One study by SM. Koch et all confirms that subsensory stimulation can be effective. At present there is no doubled blinded study's to confirm this theory of effective sub sensory stimulation.
The aim of this study is to determine if subsensory stimulation will be as effective as stimulation with amplitude at sensory threshold. This will be investigated in 20 patients who have had at least a reduction in incontinence episodes or Wexner inc. score of 75 % between preimplantation and latest follow up. The patients will be randomized to three different amplitudes. 1: amplitude set at sensory threshold. 2: 75% of sensory threshold. 3: 50% of sensory threshold. The order of the three settings will be random and in a double blinded manner. The interval between these three pacemaker settings is four weeks. Patients serve as there own controls. Stimulation frequency (14 Hz) and pulse width (210 mic-sec) will remain fixed.
Evaluation will be by means of 4 week bowel habit diary and questionnaires (Wexner inc. score / St. Marks Score / Wexner constipation score / Altomares OD-score / IBS-score/ Rockwood FIQoL -score). All patients will be evaluated with anorectal measurements (sphincter strength and anorectal volume measurements) before any changes of stimulation amplitude.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
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Aarhus C
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Aarhus, Aarhus C, Dänemark, 8000
- Anal Physiology Laboratory, Surgical Research Section 900, Aarhus University Hospital
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- 18 years or older
- Informed consent
- Idiopathic fecal incontinence or Fecal incontinence due to small sphincter defect(≤60 o)
- fecal incontinence after primary/secondary sphincter repair
- Permanent neuromodulator (medtronic InterStim / Interstim II) implanted for at least 12 weeks before entering the study.
- Reduction in fecal incontinence episodes of at least 75% between baseline and latest follow up.(Bowel diary card) or 75% reduction of Wexner Inc. score.
- Willing and competent to fill out diary cards
Exclusion Criteria:
- Colorectal/proctological surgery since IPG-implant
- Pregnancy
- Anorectal Pain
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Crossover-Aufgabe
- Maskierung: Doppelt
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Aktiver Komparator: Sensory threshold - Amplitude
Stimulation amplitude set at sensory threshold.
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Sacral nerve stimulation with amplitude (sensory threshold), Frequency 14 Hz and pulse width 210 mic.sec.
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Experimental: 25% below sensory threshold - Amplitude
Stimulation amplitude 75% of sensory threshold.
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Sacral nerve stimulation with amplitude (75% of sensory threshold), Frequency 14 Hz and pulse width 210 mic.sec.
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Experimental: 50% below sensory threshold - Amplitude
Stimulation with amplitude set 50% below sensory threshold
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Sacral nerve stimulation with amplitude (50% of sensory threshold), Frequency 14 Hz and pulse width 210 mic.sec.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Number of incontinence episodes Assess number of incontinence episodes.
Zeitfenster: Will be assessed every four weeks during a twelve-week period
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Assess number of incontinence episodes, by means of bowel habit diary.
Four week bowel habit diary will be evaluated three times during the twelve-week protocol perioed.
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Will be assessed every four weeks during a twelve-week period
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Assess changes in anorectal volume and pressure with different amplitude.
Zeitfenster: Will be assessed every four weeks during a twelve-week period
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Resting and maximal anal sphincter pressure will be measured with different amplitude settings.
In total three evaluations will be made in the twelve week protocol perioed.
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Will be assessed every four weeks during a twelve-week period
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Assess Quality of life after decrease in stimulation amplitude.
Zeitfenster: Will be assessed every four weeks during a twelve-week period
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Quality of life will be recorded by means of Rockwood faecal incontinence quality of life score.
A total of three evaluations will be made every fourth week in the twelve week protocol perioed.
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Will be assessed every four weeks during a twelve-week period
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Mitarbeiter und Ermittler
Sponsor
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- 002 (University of CT Health Center)
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