The SLIM Study: Sling and Botox® Injection for Mixed Urinary Incontinence
Primary Purpose
Mixed Urinary Incontinence, Stress Urinary Incontinence, Urgency Incontinence
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
OnabotulinumtoxinA (Botox ®) Injections
Saline Injections
Sponsored by
About this trial
This is an interventional treatment trial for Mixed Urinary Incontinence
Eligibility Criteria
Inclusion Criteria:
- Undergoing mid-urethral sling surgery
- Have symptoms of both stress and urgency urinary incontinence
- Able to consent, fill out study documents, and complete all study procedures and follow-up visits
- At least 18 years of age
- English speaking
- Be able and willing to learn clean intermittent self catheterization technique
Exclusion Criteria:
- History of recurrent UTI (defined as three culture proven UTIs within last 12 months)
- Systemic neuromuscular disease known to affect the lower urinary tract
- Undergoing concomitant prolapse surgery
- Previous incontinence surgery
- Treatment with anticholinergic medication in the last 2 months
- Previous bladder injection with onabotulinumtoxinA
- Prisoner Status
- Pregnancy
Sites / Locations
- Northwestern Medicine Integrated Pelvic Health Clinic
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Sham Comparator
Arm Label
OnabotulinumtoxinA injections
Saline injections
Arm Description
100 units of OnabotulinumtoxinA (Botox®) injected into the detrusor (large muscle of the bladder) at the time of sling surgery.
100 units of saline injected into the detrusor (large muscle of the bladder) at the time of sling surgery.
Outcomes
Primary Outcome Measures
Number of Participants With Self-reported Mixed Urinary Incontinence Symptoms
Mixed urinary incontinence symptoms will be assessed by the Patient Global Assessment of Improvement (PGI-I) survey, a patient oriented outcome
Secondary Outcome Measures
Incontinence Episode Frequency
Incontinence episode frequency will be assessed by a self-report 3-day urinary diary completed by the subject
Urinary Incontinence Symptoms and Quality of Life
Urinary incontinence symptoms and quality of life will be assessed by a satisfaction survey completed by the subject. The scale is 0-100. and higher scores indicate worse outcomes.
Full Information
NCT ID
NCT02678377
First Posted
February 5, 2016
Last Updated
February 16, 2023
Sponsor
Northwestern University
Collaborators
Friends of Prentice
1. Study Identification
Unique Protocol Identification Number
NCT02678377
Brief Title
The SLIM Study: Sling and Botox® Injection for Mixed Urinary Incontinence
Official Title
The SLIM Study: Sling and Botox® Injection for Mixed Urinary Incontinence
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
February 2016 (undefined)
Primary Completion Date
July 26, 2021 (Actual)
Study Completion Date
July 26, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Northwestern University
Collaborators
Friends of Prentice
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This double-blind randomized controlled trial seeks to find a better treatment for women with mixed urinary incontinence (both stress and urgency incontinence). The primary aim is to determine whether midurethral sling surgery combined with injections of onabotulinumtoxinA (Botox®) into the detrusor muscle of the bladder improves symptoms of mixed urinary incontinence better than sling surgery alone.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mixed Urinary Incontinence, Stress Urinary Incontinence, Urgency Incontinence
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Actual)
8. Arms, Groups, and Interventions
Arm Title
OnabotulinumtoxinA injections
Arm Type
Active Comparator
Arm Description
100 units of OnabotulinumtoxinA (Botox®) injected into the detrusor (large muscle of the bladder) at the time of sling surgery.
Arm Title
Saline injections
Arm Type
Sham Comparator
Arm Description
100 units of saline injected into the detrusor (large muscle of the bladder) at the time of sling surgery.
Intervention Type
Drug
Intervention Name(s)
OnabotulinumtoxinA (Botox ®) Injections
Other Intervention Name(s)
Botox ®
Intervention Description
OnabotulinumtoxinA (Botox ®) is a neurotoxin, which inhibits acetylcholine release and temporarily relaxes the bladder muscle to inhibit urgency incontinence.
Intervention Type
Drug
Intervention Name(s)
Saline Injections
Intervention Description
Saline will be injected into the bladder so that investigators are masked to subject randomization.
Primary Outcome Measure Information:
Title
Number of Participants With Self-reported Mixed Urinary Incontinence Symptoms
Description
Mixed urinary incontinence symptoms will be assessed by the Patient Global Assessment of Improvement (PGI-I) survey, a patient oriented outcome
Time Frame
3 months after surgery
Secondary Outcome Measure Information:
Title
Incontinence Episode Frequency
Description
Incontinence episode frequency will be assessed by a self-report 3-day urinary diary completed by the subject
Time Frame
3 months after surgery
Title
Urinary Incontinence Symptoms and Quality of Life
Description
Urinary incontinence symptoms and quality of life will be assessed by a satisfaction survey completed by the subject. The scale is 0-100. and higher scores indicate worse outcomes.
Time Frame
3 months after surgery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Undergoing mid-urethral sling surgery
Have symptoms of both stress and urgency urinary incontinence
Able to consent, fill out study documents, and complete all study procedures and follow-up visits
At least 18 years of age
English speaking
Be able and willing to learn clean intermittent self catheterization technique
Exclusion Criteria:
History of recurrent UTI (defined as three culture proven UTIs within last 12 months)
Systemic neuromuscular disease known to affect the lower urinary tract
Undergoing concomitant prolapse surgery
Previous incontinence surgery
Treatment with anticholinergic medication in the last 2 months
Previous bladder injection with onabotulinumtoxinA
Prisoner Status
Pregnancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kimberly Kenton, M.D.
Organizational Affiliation
Professor, Departments of Obstetrics and Gynecology, Urology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northwestern Medicine Integrated Pelvic Health Clinic
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
33278293
Citation
Komar A, Bretschneider CE, Mueller MG, Lewicky-Gaupp C, Collins S, Geynisman-Tan J, Tavathia M, Kenton K. Concurrent Retropubic Midurethral Sling and OnabotulinumtoxinA for Mixed Urinary Incontinence: A Randomized Controlled Trial. Obstet Gynecol. 2021 Jan 1;137(1):12-20. doi: 10.1097/AOG.0000000000004198.
Results Reference
result
Learn more about this trial
The SLIM Study: Sling and Botox® Injection for Mixed Urinary Incontinence
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