search
Back to results

InterStim® Sacral Nerve Modulation Cycling Study

Primary Purpose

Urinary Urge Incontinence

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
InterStim® (Device Programming)
Sponsored by
MedtronicNeuro
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Urge Incontinence focused on measuring Urinary, Urge, Incontinence

Eligibility Criteria

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

Inclusion Criteria:

  1. Implanted with either Neurostimulator Model 3023 (InterStim) or Neurostimulator Model 3058 (InterStim II) for at least 3 months
  2. Implanted with tined lead models 3889 or 3093
  3. Tined lead is located at S3 as determined by sensory or motor responses or x-ray or fluoroscopy
  4. Currently showing some efficacy with an InterStim device but has the potential to be optimized per the opinion of the Investigator
  5. Primary diagnosis before InterStim implant is urinary urge incontinence.
  6. Must be willing to maintain her current regimen (dosage and frequency) of any overactive bladder (OAB) medication (anticholinergic, antimuscarinic or Myrbetriq (Mirabegron)) or tricyclic antidepression medication over the study duration, if applicable.
  7. Female subject 18 years of age or older
  8. Willing and able to accurately complete voiding diaries and questionnaires, attend visits (within the visit windows +7 days), and comply with the study protocol that includes maintenance of InterStim programming settings over the course of the study
  9. Have had no more than one (InterStim) reprogramming at or within 28 days at or prior to randomization
  10. Able to consent to participate by signing the Informed Consent Form

    Exclusion Criteria:

  11. History of Multiple sclerosis
  12. History of Reiter's syndrome
  13. History of spinal cord injury or a cerebral vascular accident (CVA)
  14. History of diabetes unless the diabetes is well-controlled through diet and/or medications
  15. Active symptomatic urinary tract infection (UTI)
  16. Stress incontinence as the primary diagnosis
  17. Urgency frequency as a primary diagnosis
  18. Pelvic pain of uncertain etiology that is not associated with a voiding dysfunction or where pelvic pain is the primary diagnosis
  19. Interstitial cystitis as the primary diagnosis
  20. Urinary retention as the primary diagnosis
  21. Treatment of urinary symptoms with botulinum toxin in the past 12 months or any plan to have botulinum toxin treatment during the study
  22. Bilateral lead placement
  23. Have other implantable neurostimulator, pacemaker, or defibrillator
  24. Have knowledge of planned diathermy, microwave exposure, high output ultrasonic exposure, RF energy exposure, or MRI scans not included within the scanning conditions provided within the MRI Guidelines for InterStim Therapy neurostimulation systems.
  25. Have an anticipated system modification within the next 5 months
  26. Women who are pregnant or planning to become pregnant (women of child-bearing potential must undergo a pregnancy test, with a clear negative result, no more than 7 days prior to randomization visit)
  27. Subjects who frequently use the patient programmer to change device program settings ("frequently" is defined as at least once a day and does not include shutting off the device for safety purposes)
  28. Characteristics indicating a poor understanding of the study or characteristics that indicate the subject may have poor compliance with the study protocol.
  29. Study site personnel will contact the Medtronic Study Manager (or designee) to determine if a potential subject who plans to enroll in an investigational device or drug trial, or is currently enrolled in an investigational device or drug trial is eligible for this study

Sites / Locations

  • Pinellas Urology, Inc.
  • University of Iowa Healthcare
  • Metro Urology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Other

Other

Other

Other

Other

Arm Label

Continuous

Cycling Parameter #1

Cycling Parameter #2

Cycling Parameter #3

No Stimulation

Arm Description

The device parameter will be continuous.

The device parameter will be cyclic program #1.

The device parameter will be cyclic program #2.

The device parameter will be cyclic program #3.

Following the randomized portion of the study, an assessment was conducted to estimate the effect of a month of no stimulation on incontinence.

Outcomes

Primary Outcome Measures

Number of Urinary Urge Incontinent (UUI) Episodes Per Day - Randomized Portion
Urinary urge incontinent episodes were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.

Secondary Outcome Measures

Degree of Urgency - Randomized Portion
Each UUI episode was rated on following scales: 0=None, 1=Mild, 2=Moderate, 3=Severe, which were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. The average degree of urgency per UUI episode was calculated from the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Number of Pads Used Per Day - Randomized Portion
Number of pad use were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Global Response Assessment (GRA) - Randomized Portion
Summary statistics of GRA at different cycling settings are provided. The GRA assessed incontinence symptoms as compared to symptoms prior to subject's entry into the study. Subjects were asked how much their incontinence changed since starting the study: markedly worse, moderately worse, mildly worse, same, slightly improved, moderately improved, or markedly improved. The responses to the symptom change were categorized into three levels for the analysis: worse (markedly worse, moderately worse, mildly worse), same (same), better (slightly improved, moderately improved, or markedly improved). Percentages of subjects reported worse, same or better under each cycling setting since starting the study are presented.
Number of UUI Episodes Per Day - no Stimulation
UUI episodes were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Degree of Urgency - no Stimulation
Each UUI episode was rated on following scales: 0=None, 1=Mild, 2=Moderate, 3=Severe, which were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. The average degree of urgency per UUI episode was calculated from the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Number of Pads Used Per Day - no Stimulation
Number of pad use were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Global Response Assessment - no Stimulation
Summary of GRA under no stimulation setting is provided. The GRA assessed incontinence symptoms as compared to symptoms prior to subject's entry into the study. Subjects were asked how much their incontinence changed since starting the study: markedly worse, moderately worse, mildly worse, same, slightly improved, moderately improved, or markedly improved. The responses to the symptom change were categorized into three levels for the analysis: worse (markedly worse, moderately worse, mildly worse), same (same), better (slightly improved, moderately improved, or markedly improved).
Adverse Events - no Stimulation
Summary of adverse device effects when subjects were under no stimulation is provided. Percentage of subjects experiencing any type of Adverse Device Effect under no stimulation is presented.

Full Information

First Posted
June 25, 2013
Last Updated
November 14, 2017
Sponsor
MedtronicNeuro
search

1. Study Identification

Unique Protocol Identification Number
NCT01957137
Brief Title
InterStim® Sacral Nerve Modulation Cycling Study
Official Title
InterStim® Sacral Nerve Modulation Cycling Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
September 2013 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MedtronicNeuro

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The study will assess the effects of different InterStim cycling settings on urinary urge incontinence.
Detailed Description
This feasibility study will assess the following outcomes: Voiding diaries Patient reported assessments of response or satisfaction Adverse events

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Participant
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Continuous
Arm Type
Other
Arm Description
The device parameter will be continuous.
Arm Title
Cycling Parameter #1
Arm Type
Other
Arm Description
The device parameter will be cyclic program #1.
Arm Title
Cycling Parameter #2
Arm Type
Other
Arm Description
The device parameter will be cyclic program #2.
Arm Title
Cycling Parameter #3
Arm Type
Other
Arm Description
The device parameter will be cyclic program #3.
Arm Title
No Stimulation
Arm Type
Other
Arm Description
Following the randomized portion of the study, an assessment was conducted to estimate the effect of a month of no stimulation on incontinence.
Intervention Type
Device
Intervention Name(s)
InterStim® (Device Programming)
Primary Outcome Measure Information:
Title
Number of Urinary Urge Incontinent (UUI) Episodes Per Day - Randomized Portion
Description
Urinary urge incontinent episodes were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Degree of Urgency - Randomized Portion
Description
Each UUI episode was rated on following scales: 0=None, 1=Mild, 2=Moderate, 3=Severe, which were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. The average degree of urgency per UUI episode was calculated from the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 week
Title
Number of Pads Used Per Day - Randomized Portion
Description
Number of pad use were collected through a diary on daily basis for approximately 4 weeks when subjects were under each cycling setting. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 weeks
Title
Global Response Assessment (GRA) - Randomized Portion
Description
Summary statistics of GRA at different cycling settings are provided. The GRA assessed incontinence symptoms as compared to symptoms prior to subject's entry into the study. Subjects were asked how much their incontinence changed since starting the study: markedly worse, moderately worse, mildly worse, same, slightly improved, moderately improved, or markedly improved. The responses to the symptom change were categorized into three levels for the analysis: worse (markedly worse, moderately worse, mildly worse), same (same), better (slightly improved, moderately improved, or markedly improved). Percentages of subjects reported worse, same or better under each cycling setting since starting the study are presented.
Time Frame
4 weeks
Title
Number of UUI Episodes Per Day - no Stimulation
Description
UUI episodes were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 Weeks
Title
Degree of Urgency - no Stimulation
Description
Each UUI episode was rated on following scales: 0=None, 1=Mild, 2=Moderate, 3=Severe, which were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. The average degree of urgency per UUI episode was calculated from the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 weeks
Title
Number of Pads Used Per Day - no Stimulation
Description
Number of pad use were collected through a diary on daily basis for approximately 4 weeks when subjects were under no stimulation. Only the last 7-day diaries were used for the analysis. The first 3 weeks were used as an adjustment period.
Time Frame
4 Weeks
Title
Global Response Assessment - no Stimulation
Description
Summary of GRA under no stimulation setting is provided. The GRA assessed incontinence symptoms as compared to symptoms prior to subject's entry into the study. Subjects were asked how much their incontinence changed since starting the study: markedly worse, moderately worse, mildly worse, same, slightly improved, moderately improved, or markedly improved. The responses to the symptom change were categorized into three levels for the analysis: worse (markedly worse, moderately worse, mildly worse), same (same), better (slightly improved, moderately improved, or markedly improved).
Time Frame
4 Weeks
Title
Adverse Events - no Stimulation
Description
Summary of adverse device effects when subjects were under no stimulation is provided. Percentage of subjects experiencing any type of Adverse Device Effect under no stimulation is presented.
Time Frame
4 Weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Implanted with either Neurostimulator Model 3023 (InterStim) or Neurostimulator Model 3058 (InterStim II) for at least 3 months Implanted with tined lead models 3889 or 3093 Tined lead is located at S3 as determined by sensory or motor responses or x-ray or fluoroscopy Currently showing some efficacy with an InterStim device but has the potential to be optimized per the opinion of the Investigator Primary diagnosis before InterStim implant is urinary urge incontinence. Must be willing to maintain her current regimen (dosage and frequency) of any overactive bladder (OAB) medication (anticholinergic, antimuscarinic or Myrbetriq (Mirabegron)) or tricyclic antidepression medication over the study duration, if applicable. Female subject 18 years of age or older Willing and able to accurately complete voiding diaries and questionnaires, attend visits (within the visit windows +7 days), and comply with the study protocol that includes maintenance of InterStim programming settings over the course of the study Have had no more than one (InterStim) reprogramming at or within 28 days at or prior to randomization Able to consent to participate by signing the Informed Consent Form Exclusion Criteria: History of Multiple sclerosis History of Reiter's syndrome History of spinal cord injury or a cerebral vascular accident (CVA) History of diabetes unless the diabetes is well-controlled through diet and/or medications Active symptomatic urinary tract infection (UTI) Stress incontinence as the primary diagnosis Urgency frequency as a primary diagnosis Pelvic pain of uncertain etiology that is not associated with a voiding dysfunction or where pelvic pain is the primary diagnosis Interstitial cystitis as the primary diagnosis Urinary retention as the primary diagnosis Treatment of urinary symptoms with botulinum toxin in the past 12 months or any plan to have botulinum toxin treatment during the study Bilateral lead placement Have other implantable neurostimulator, pacemaker, or defibrillator Have knowledge of planned diathermy, microwave exposure, high output ultrasonic exposure, RF energy exposure, or MRI scans not included within the scanning conditions provided within the MRI Guidelines for InterStim Therapy neurostimulation systems. Have an anticipated system modification within the next 5 months Women who are pregnant or planning to become pregnant (women of child-bearing potential must undergo a pregnancy test, with a clear negative result, no more than 7 days prior to randomization visit) Subjects who frequently use the patient programmer to change device program settings ("frequently" is defined as at least once a day and does not include shutting off the device for safety purposes) Characteristics indicating a poor understanding of the study or characteristics that indicate the subject may have poor compliance with the study protocol. Study site personnel will contact the Medtronic Study Manager (or designee) to determine if a potential subject who plans to enroll in an investigational device or drug trial, or is currently enrolled in an investigational device or drug trial is eligible for this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven W Siegel, MD
Organizational Affiliation
Metro Urology
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Shaw Zhou, MD
Organizational Affiliation
Pinellas Urology, Inc.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Karl Kreder, Jr., MD, MBA
Organizational Affiliation
University of Iowa Healthcare
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pinellas Urology, Inc.
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33710
Country
United States
Facility Name
University of Iowa Healthcare
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Metro Urology
City
Woodbury
State/Province
Minnesota
ZIP/Postal Code
55125
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
28914707
Citation
Siegel S, Kreder K, Takacs E, McNamara R, Kan F. Prospective Randomized Feasibility Study Assessing the Effect of Cyclic Sacral Neuromodulation on Urinary Urge Incontinence in Women. Female Pelvic Med Reconstr Surg. 2018 Jul/Aug;24(4):267-271. doi: 10.1097/SPV.0000000000000457.
Results Reference
result

Learn more about this trial

InterStim® Sacral Nerve Modulation Cycling Study

We'll reach out to this number within 24 hrs