Vaginal Electrical Stimulation Versus Neuromodulation (Estim)
Vaginal Electrical Stimulation Versus Sacral Neuromodulation for the Treatment of Refractory Overactive Bladder: A Pilot Study
This prospective study compares quality of life measures of patients with refractory overactive bladder, between two modes of neuromodulation: vaginal electrical stimulation (Group A) and sacral nerve stimulation (Group B).
The specific aims are:
1. To characterize patient symptom bother score, quality of life, and body image scores in patients obtaining sacral nerve stimulation, as compared to vaginal electrical stimulation.
- Hypothesis 1: Both modes of neuromodulation will impact patients' scores in quality of life, patient symptoms, and body image questionnaires.
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
All participants will have a standardized intake history which will include age, weight, history of prior treatment for incontinence, medication list, obstetric and gynecologic history, medical history, and surgical history, as well as a complete review of systems. The physical examination will include vital signs (including BMI), genitourinary exam, including Pelvic Organ Prolapse Quantification (POPQ), and neurologic exam. All patients will undergo spontaneous uroflowmetry, urine dipstick from catheterized specimen, multichannel urodynamics, and 3-day voiding diary. Measurement of post-void residual will also be obtained. Completion of the UDI-69, King's Health Questionnaire10, and the Modified Body Image Perception Scale (MBIS) will also be part of the initial visit 11,12.
All participants taking anticholinergics will undergo a 2 week flush-out period prior to the intake assessment. After the intake assessment, the provider will determine which treatment option is appropriate to the participant, and they will then be assigned to one of the two treatment arms: Group A will use vaginal electrical stimulation using the Empi Intravaginal Stimulation Unit Minnova (Empi, St. Paul, MN, USA) and participants in Group B will receive sacral neuromodulation using InterStim (Medtronic, Minneapolis, MN, USA).
Studientyp
Einschreibung (Tatsächlich)
Kontakte und Standorte
Studienorte
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Oklahoma
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Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
- University of Oklahoma Health Sciences Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- Diagnosis of refractory OAB (+/- UUI)*
- Female Gender
- Eligible for both treatment interventions
- Available for 8 weeks of follow-up
- Able to complete study assessments
- Must discontinue anticholinergics within 2 weeks of intervention
Exclusion Criteria:
- Age < 21
- Pregnancy
- Stage 3 or 4 pelvic organ prolapse
- Current use of anticholinergics
- Urinary tract infection
- Undergoing concurrent treatment for pelvic organ prolapse
- Unstable or serious cardiac arrhythmia
- Implanted pacemaker
- Postvoid residual > 100ml
- Unstable seizure disorder
- Dementia or inability to follow instructions
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Kohorten und Interventionen
Gruppe / Kohorte |
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Electrical Stimulation
Participants will have a dedicated visit with a pelvic floor physical therapist during which instructions on usage and technique for the Minnova unit will be given.
The electrical parameters selected will be: 10 Hertz frequency, 5-second on/10=second off cycle, and a pulse width of 0.4 milliseconds.
The bipolar square will be delivered over a range that varies from 0 to 100 milliamps, depending on the maximum current intensity comfortably tolerated by the patient.
The participant will perform each treatment session for 20 minutes twice daily for 8 weeks.
Participants will be asked to keep a log recording the dates, times, and duration of each treatment session.
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Interstim device
Participants assigned to the sacral neuromodulation group will undergo InterStim device placement by one of the three Urogynecologists at OUHSC using a staged implant technique according to manufacturer's specifications.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Symptom improvement
Zeitfenster: 3 months
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>50% improvement in symptoms and decrease in frequency of voids and episodes of nocturia.
Subjective outcomes will be measured by improvement in scores on the UDI-6, KHG, and MBIS.
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3 months
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Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: S. Abbas Shobeiri, MD, Univerisity of Oklahoma Health Sciences Center
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
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- 1104
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