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Sacral Nerve Stimulation to Treat Urgency Urinary Incontinence With Wireless Neuromodulation

Primary Purpose

Urinary Incontinence, Urge

Status
Withdrawn
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
StimGuard Sacral Nerve Stimulator System
Sponsored by
Uro Medical Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Incontinence, Urge

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

A. Diagnosis of overactive bladder with urgency urinary incontinence; B. Women and men ≥ 18 years of age; C. At least 4 incontinent episodes associated with urge on a 3 day voiding diary with at least 1 each 24 hour day; D. Self-reported bladder symptoms present > 6 months; E. Self-reported failed conservative care > 6 months (i.e., pharmacology, dietary restriction, fluid restriction, bladder training, behavioral modification, pelvic muscle training, biofeedback, etc.); F. Off all antimuscarinics and beta-3 adrenergic agonists for at least 2 weeks prior to enrollment; G. Have no reported history of urethral obstruction/stricture, bladder calculi or bladder tumor; H. Normal upper urinary tract function; I. Capable of giving informed consent; J. Capable and willing to follow all study related procedures.

Exclusion Criteria:

A. Any active implantable electronic device regardless of whether stimulation is ON or OFF; B. Pregnant as confirmed by a urine pregnancy test or plan to become pregnant during the following 12 months period; C. Less than 1 year post partum and/or are breast-feeding; D. Neurogenic bladder; E. Botox use in bladder or pelvic floor muscles in the past six months; F. Taking alpha-blocker therapy; G. Have a PVR >150 cc at baseline; H. Primary complaint of stress urinary incontinence; I. Current urinary tract infection (UTI); J. Previous treatment with sacral neuromodulation; K. Previous treatment with tibial nerve stimulation, pelvic floor muscle stimulation, or biofeedback within the past 60 days; L. Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures; M. Inability to operate the StimGuard SNS System; N. Diabetes with peripheral nerve involvement or have severe uncontrolled diabetes (HbA1C 8.5 or greater); O. History of coagulopathy or bleeding disorder; P. History of pelvic pain as primary diagnosis (VAS score of > 4); Q. Anatomical restrictions such that device placement is not possible; R. Currently participating or have participated within the past 30 days in any clinical investigation involving or impacting urinary or renal function; S. Life expectancy of less than 5 years; T. Inability to independently comprehend and complete the questionnaires and diaries; U. Unsuitable for enrollment in study by the investigators based on subjects' history or physical examination (including bleeding disorders or anticoagulant medications, and peripheral neuropathy).

Sites / Locations

  • Beaumont Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Immediate Activation

Delayed Activation

Arm Description

Subjects randomized to this group will have the StimGuard Sacral Nerve Stimulator System activated immediately.

Subjects randomized to this group will have the StimGuard Sacral Nerve Stimulator System activated after 90 days.

Outcomes

Primary Outcome Measures

Reduction in number of urge related incontinence episodes
Self reported on a 3-day voiding diary
Incidence and severity of adverse events

Secondary Outcome Measures

Proportion of subjects with a reduction in the degree of urgency as measured by PPIUS
Self reported on a 3-day voiding diary
Proportion of subjects with a reduction in the number of voids compared to baseline
Self reported on a 3-day voiding diary
Improved quality of life function via the Incontinence Quality of Life Scale (I-QOL)
Quesionnaire

Full Information

First Posted
April 30, 2015
Last Updated
September 28, 2020
Sponsor
Uro Medical Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT02434874
Brief Title
Sacral Nerve Stimulation to Treat Urgency Urinary Incontinence With Wireless Neuromodulation
Official Title
Randomized, Multi-Center Pivotal Study for Sacral Nerve Stimulation to Treat Refractory Urgency Urinary Incontinence With Wireless Neuromodulation Technology
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Study will no longer take place, the study did not begin or accrue subjects.
Study Start Date
March 2020 (Anticipated)
Primary Completion Date
December 2021 (Anticipated)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Uro Medical Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this pivotal study is to illustrate the safety and effectiveness of the StimGuard Sacral Nerve Stimulation (SNS) System in the treatment refractory urge incontinence. This is a prospective, randomized, controlled, multi-center, study in which 92 subjects will receive a StimGuard SNS System.
Detailed Description
The StimGuard SNS System is utilized for the treatment of refractory urgency urinary incontinence as defined by the International Continence Society (ICS) Standardization of Terminology Committees Joint Report as the observation of involuntary leakage from the urethra synchronous with the sensation of a sudden, compelling desire to void that is difficult to defer. The system provides treatment by delivering small controlled electrical pulses to the sacral nerves, as these nerves have been shown to regulate the micturition cycle. In this study, subjects will be randomized into one of two groups with a 1:1 ratio after enrollment. Subjects will either be randomized to an immediate or a delayed activation group. An intraoperative test will be performed, and all subjects will receive a permanent implant if they have an appropriate motor nerve root response without significant discomfort at 5 mA amplitude or less.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Incontinence, Urge

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Immediate Activation
Arm Type
Experimental
Arm Description
Subjects randomized to this group will have the StimGuard Sacral Nerve Stimulator System activated immediately.
Arm Title
Delayed Activation
Arm Type
Other
Arm Description
Subjects randomized to this group will have the StimGuard Sacral Nerve Stimulator System activated after 90 days.
Intervention Type
Device
Intervention Name(s)
StimGuard Sacral Nerve Stimulator System
Intervention Description
The StimGuard Sacral Nerve Stimulator System is a wirelessly powered neurostimulator for urge urinary incontinence. This technology includes a quadripolar stimulator with an embedded receiver. The energy source is a small, external, rechargeable transmitter, which is worn by the patient. The transmitter sends the therapy program and power through the skin and to the receiver.
Primary Outcome Measure Information:
Title
Reduction in number of urge related incontinence episodes
Description
Self reported on a 3-day voiding diary
Time Frame
3 Months
Title
Incidence and severity of adverse events
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Proportion of subjects with a reduction in the degree of urgency as measured by PPIUS
Description
Self reported on a 3-day voiding diary
Time Frame
3 Months
Title
Proportion of subjects with a reduction in the number of voids compared to baseline
Description
Self reported on a 3-day voiding diary
Time Frame
3 Months
Title
Improved quality of life function via the Incontinence Quality of Life Scale (I-QOL)
Description
Quesionnaire
Time Frame
3 Months
Other Pre-specified Outcome Measures:
Title
Proportion of subjects dry
Description
Self reported on a 3-day voiding diary
Time Frame
12 months
Title
Number of Episodes associated with urge
Description
Self reported on a 3-day voiding diary
Time Frame
12 months
Title
Proportion of subjects reporting improvement
Description
Measured by Global Response Assessment as "moderately" or "markedly improved"
Time Frame
12 Months
Title
Improved quality of life function via Overactive Bladder Questionnaire (OAB-Q)
Description
Questionnaire
Time Frame
12 Months
Title
Improved quality of life function via Idiopathic Overactive Bladder Symptom Score (iOABSS)
Description
Questionnaire
Time Frame
12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A. Diagnosis of overactive bladder with urgency urinary incontinence; B. Women and men ≥ 18 years of age; C. At least 4 incontinent episodes associated with urge on a 3 day voiding diary with at least 1 each 24 hour day; D. Self-reported bladder symptoms present > 6 months; E. Self-reported failed conservative care > 6 months (i.e., pharmacology, dietary restriction, fluid restriction, bladder training, behavioral modification, pelvic muscle training, biofeedback, etc.); F. Off all antimuscarinics and beta-3 adrenergic agonists for at least 2 weeks prior to enrollment; G. Have no reported history of urethral obstruction/stricture, bladder calculi or bladder tumor; H. Normal upper urinary tract function; I. Capable of giving informed consent; J. Capable and willing to follow all study related procedures. Exclusion Criteria: A. Any active implantable electronic device regardless of whether stimulation is ON or OFF; B. Pregnant as confirmed by a urine pregnancy test or plan to become pregnant during the following 12 months period; C. Less than 1 year post partum and/or are breast-feeding; D. Neurogenic bladder; E. Botox use in bladder or pelvic floor muscles in the past six months; F. Taking alpha-blocker therapy; G. Have a PVR >150 cc at baseline; H. Primary complaint of stress urinary incontinence; I. Current urinary tract infection (UTI); J. Previous treatment with sacral neuromodulation; K. Previous treatment with tibial nerve stimulation, pelvic floor muscle stimulation, or biofeedback within the past 60 days; L. Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures; M. Inability to operate the StimGuard SNS System; N. Diabetes with peripheral nerve involvement or have severe uncontrolled diabetes (HbA1C 8.5 or greater); O. History of coagulopathy or bleeding disorder; P. History of pelvic pain as primary diagnosis (VAS score of > 4); Q. Anatomical restrictions such that device placement is not possible; R. Currently participating or have participated within the past 30 days in any clinical investigation involving or impacting urinary or renal function; S. Life expectancy of less than 5 years; T. Inability to independently comprehend and complete the questionnaires and diaries; U. Unsuitable for enrollment in study by the investigators based on subjects' history or physical examination (including bleeding disorders or anticoagulant medications, and peripheral neuropathy).
Facility Information:
Facility Name
Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States

12. IPD Sharing Statement

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Sacral Nerve Stimulation to Treat Urgency Urinary Incontinence With Wireless Neuromodulation

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