- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT05762198
Un essai contrôlé randomisé comparant la thérapie thermique à la vapeur d'eau (Rezūm) et la TURP
Un essai contrôlé randomisé comparant la thérapie thermique à la vapeur d'eau (Rezūm) et la TURP chez les hommes atteints d'hyperplasie bénigne de la prostate en cas de rétention urinaire réfractaire
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.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Hong Kong, Hong Kong
- Prince of Wales Hospital, Chinese University of Hong Kong
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Comparateur actif: Rezūm
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In the REZUM arm, water vapour treatment is performed for all subjects under local anaesthesia. |
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Comparateur actif: TURP
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In the TURP arm, all men will receive TURP operation under general or spinal anaesthesia |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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International Prostate Symptom Score (IPSS) at 12 months after treatment
Délai: 3 months, 6 months and 12 months after intervention
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IPSS score ranging from 0-35 (the higher the worse) |
3 months, 6 months and 12 months after intervention
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Successful trial without catheter (TWOC) within 3 months
Délai: At 3 months
|
Percentage of patients successfully TWOC |
At 3 months
|
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Complication rate
Délai: 30 days after intervention
|
Assessed by Clavien-Dindo classification |
30 days after intervention
|
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Post-op quality of life score
Délai: 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
|
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Change in voiding function in uroflowmetry
Délai: 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
|
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Post-op Erectile Function Domain of the International Index of Erectile Function score
Délai: 3 months, 6 months and 12 months after intervention
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Score 1-5 (the lower the worse) |
3 months, 6 months and 12 months after intervention
|
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Hospital stays of procedure
Délai: During hospitalization, assessed at discharge
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Measure the hours of in-patient hospitalisation |
During hospitalization, assessed at discharge
|
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Unplanned readmission rate after operation in 30 days
Délai: 30 days after intervention
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Percentage of patients with unplanned readmission |
30 days after intervention
|
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Bladder outlet obstruction index (BOOI) by Urodynamic studies
Délai: Performed at 12 months after treatment
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Performed at 12 months after treatment
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Bladder contractility index (BCI) by Urodynamic studies
Délai: Performed at 12 months after treatment
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Performed at 12 months after treatment
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Peter Ka-Fung CHIU, FRCS, PhD, Chinese University of Hong Kong
Publications et liens utiles
Publications générales
- 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.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies urogénitales
- Maladies génitales
- Maladies génitales, sexe masculin
- Maladies de la prostate
- Maladies urogénitales masculines
- Hyperplasie prostatique
- Procédures chirurgicales, opératoires
- Procédures chirurgicales urologiques
- Procédures chirurgicales urogénitales
- Procédures chirurgicales urologiques, mâle
- Prostatectomie
- Résection transurétrale de la prostate
Autres numéros d'identification d'étude
- CRE-2022.537-T
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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