Catheter Extension Trial for Early Vesicovaginal Fistula Repair Failures
Primary Purpose
Vesico Vaginal Fistula
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Catheter extension
Sponsored by
About this trial
This is an interventional treatment trial for Vesico Vaginal Fistula focused on measuring vesicovaginal fistula, urinary catheter, catheter extension
Eligibility Criteria
Inclusion Criteria:
- Women who present with a vesicovaginal fistula for surgical repair AND who, at the time of initial catheter removal (7 or 14 days post-repair), have demonstrable fistulous leak on dye test
Exclusion Criteria:
- HIV infection,
- concomitant bladder stone(s),
- one or more ureters outside of the bladder,
- urethrovaginal fistula,
- multiple fistulas (more than one),
- dye leak / fistulous leak present at end of surgical procedure,
- radiation-induced fistula,
- fistula caused by cancer or infection (such as lymphogranuloma venereum),
- continence procedures being performed (such as pubovaginal sling),
- rectovaginal fistula,
- pregnancy,
- fistula breakdown of greater than 2cm identified on postoperative dye test.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Catheter Extension
Discharge
Arm Description
Patients in this arm will have a foley catheter re-passed, to remain in situ for an additional 14 days, after which time the catheter will be removed and the patient discharged to return for follow up exam at 3 months postop.
Patients in this arm will be discharged, to return for follow up exam at 3 months postop.
Outcomes
Primary Outcome Measures
Fistula closure
Successful closure of the fistula, as defined by patient self-reporting no urinary leakage AND a negative dye test proving no fistulous leak
Secondary Outcome Measures
Urinary continence
Patient is completely continent of urine with no reported OR demonstrable leakage of dye on inspection.
Closure and continence at hospital discharge
Rates of fistula closure and complete urinary continence at the time of hospital discharge
Complications
Rates of complications or urinary tract infections during hospitalization
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03029130
Brief Title
Catheter Extension Trial for Early Vesicovaginal Fistula Repair Failures
Official Title
Does Extending Catheterization Improve Outcomes in Early Vesicovaginal Fistula Repair Failures? A Prospective Randomized Controlled Trial
Study Type
Interventional
2. Study Status
Record Verification Date
January 2017
Overall Recruitment Status
Unknown status
Study Start Date
January 1, 2017 (Actual)
Primary Completion Date
December 31, 2019 (Anticipated)
Study Completion Date
March 31, 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Evangel VVF Centre
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study evaluates the use of extending time of continual urinary drainage (using transurethral foley catheter) for patients with early failures of vesicovaginal fistula repairs. Half of those included will be randomized to replacement of foley catheter for a length of 14 additional days, while the other half will be discharged (no intervention). Both groups will be examined for outcomes at 3 months post-repair.
Detailed Description
At present, there is no standard of care nor consensus for the proper management of repaired vesicovaginal fistulas that begin leaking prior to or immediately after scheduled catheter removal. In the past, extension of time with catheterization has been tried, with patients becoming fully healed by the time of catheter removal. However, some patients who are discharged with a fistulous leak later return at follow up completely dry, with a closed and healed fistula. This study will compare, in a prospective, randomized manner, extension of catheterization vs no intervention, to see if in such patients extending catheterization will improve their likelihood of complete fistula healing.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vesico Vaginal Fistula
Keywords
vesicovaginal fistula, urinary catheter, catheter extension
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
232 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Catheter Extension
Arm Type
Experimental
Arm Description
Patients in this arm will have a foley catheter re-passed, to remain in situ for an additional 14 days, after which time the catheter will be removed and the patient discharged to return for follow up exam at 3 months postop.
Arm Title
Discharge
Arm Type
No Intervention
Arm Description
Patients in this arm will be discharged, to return for follow up exam at 3 months postop.
Intervention Type
Device
Intervention Name(s)
Catheter extension
Intervention Description
Foley transurethral catheter placed to allow continuous drainage of urine.
Primary Outcome Measure Information:
Title
Fistula closure
Description
Successful closure of the fistula, as defined by patient self-reporting no urinary leakage AND a negative dye test proving no fistulous leak
Time Frame
3 months post-repair
Secondary Outcome Measure Information:
Title
Urinary continence
Description
Patient is completely continent of urine with no reported OR demonstrable leakage of dye on inspection.
Time Frame
3 months post-repair
Title
Closure and continence at hospital discharge
Description
Rates of fistula closure and complete urinary continence at the time of hospital discharge
Time Frame
Date of discharge (7-28 days post-repair)
Title
Complications
Description
Rates of complications or urinary tract infections during hospitalization
Time Frame
Duration of hospitalization (minimum 7 days, maximum 28 days post-repair)
10. Eligibility
Sex
Female
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Women who present with a vesicovaginal fistula for surgical repair AND who, at the time of initial catheter removal (7 or 14 days post-repair), have demonstrable fistulous leak on dye test
Exclusion Criteria:
HIV infection,
concomitant bladder stone(s),
one or more ureters outside of the bladder,
urethrovaginal fistula,
multiple fistulas (more than one),
dye leak / fistulous leak present at end of surgical procedure,
radiation-induced fistula,
fistula caused by cancer or infection (such as lymphogranuloma venereum),
continence procedures being performed (such as pubovaginal sling),
rectovaginal fistula,
pregnancy,
fistula breakdown of greater than 2cm identified on postoperative dye test.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Catheter Extension Trial for Early Vesicovaginal Fistula Repair Failures
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