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Urinary Stress Incontinence and Urgency in Women With EMSELLA

Primary Purpose

Stress Urinary Incontinence, Urge Incontinence

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
BTL EMSELLA
Sponsored by
San Diego Sexual Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stress Urinary Incontinence focused on measuring incontinence, stress urgency incontinence, urge incontinence, EMSELLA

Eligibility Criteria

21 Years - 80 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject provides written informed consent and HIPAA authorization before any study procedures are conducted;
  2. Subject is female;
  3. Subject is aged 21-80 years;
  4. Subject has a body mass index (BMI) < 37 kg/m2;
  5. Subject has stress urinary incontinence, urge incontinence, or mixed urinary incontinence as determined by the QUID;
  6. Subject is currently sexually active and willing to continue sexual activity throughout the study;
  7. Subject is willing to continue level of core exercise currently being performed or not performed during the study (e.g. gym, Pilates, yoga);
  8. Subject is willing to maintain her current prescription and over the counter medications throughout the study without changing them;
  9. Subject agrees to comply with the study procedures and visits.

Exclusion Criteria:

  1. Subject has used the BTL EMSELLA device previously;
  2. Subject has any significant pelvic organ prolapse;
  3. Subject has clinically significant findings on physical examination;
  4. Subject has any chronic medical condition (e.g. neurologic disorder) or psychologic disorder that the Principal Investigator feels makes her ineligible for the study;
  5. Subject is unwilling to maintain current level of exercise throughout the study;
  6. Subject has been diagnosed with overactive bladder or interstitial cystitis;
  7. Subject experiences bladder pain or scores above 0 on the pain questions on the O'Leary/Sant Voiding and Pain Indices (ICSI/ICPI);
  8. Subject experiences pain with sexual activity
  9. Subject answers anything other than "almost never or never" or "a few times" on pain questions 17 or 18 of the Female Sexual Function Index (FSFI)
  10. Subject answers anything other than "very low or none at all" or "low" on pain questions 19 of the (FSFI)
  11. Subject planning to have surgery during the study;
  12. Subject has untreated malignancy;
  13. Subject is pregnant, planning to get pregnant or within 3 months postpartum;
  14. Subject has a pacemaker;
  15. Subject has and implant or IUD containing metal (e.g. copper 7);
  16. Subject has piercing between the waist and knees and is not willing to remove it before each treatment;
  17. Subject has a history of substance abuse within 12 months prior, or consuming > 14 alcoholic drinks per week;
  18. Subject has received an investigational drug within 30 days prior to signing consent;
  19. Subject has any condition or exhibits behavior that indicates to the Principal Investigator that the Subject is unlikely to be compliant with study procedures and visits.

Sites / Locations

  • San Diego Sexual MedicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Active EMSELLA treatment

Sham EMSELLA treatment

Arm Description

6 treatments on the BTL EMSELLA using a device protocol that is active HIFEM technology

6 treatments on the BTL EMSELLA with a sham device protocol that provides some sensation without active HIFEM technology

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events
Serious adverse events and adverse events related to device will be collected to assess safety
QUID (Questionnaire for Urinary Incontinence Diagnosis)
Change in Questionnaire for Urinary Incontinence Diagnosis (QUID) from pre-treatment to each follow up visit

Secondary Outcome Measures

FSFI (Female Sexual Function Index) Orgasm Domain
Change in Orgasm Domain of the Female Sexual Function Index from pre-treatment to follow up visits. Range is 0-6 with higher the results representing better outcome
FSFI (Female Sexual Function Index)
Change in total score of the Female Sexual Function Index from pre-treatment to follow up visits. Range is 2-36, with higher results representing better the outcome, and 26.55 and above signifying no sexual dysfunction
FSDS-DAO (Female Sexual Distress Score-Desire, Arousal, Orgasm)
Change in total score of the Female Sexual Distress Score-Desire, Arousal, Orgasm from pre-treatment to follow up visits. Range is from 0-60 with lower results representing the better outcome.
ISCI (Interstitial Cystitis Symptoms Index )/ICPI (Interstitial Cystitis Problem Index)
Change in total score of the ICSI/ICPI Questionnaire from pre-treatment to follow up visits. Range is 0-35, with lower results representing the better the outcome.
Modified Oxford Scale measuring pelvic floor strength
Change in degree of force based on the modified Oxford scale measuring pelvic floor muscle strength from pre-treatment to follow up visits. Scale is a single recording from 0 (lack of muscle response) to 5 (strong contraction, firm compression) with higher results representing the better the outcome.

Full Information

First Posted
January 30, 2019
Last Updated
October 8, 2023
Sponsor
San Diego Sexual Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT03877640
Brief Title
Urinary Stress Incontinence and Urgency in Women With EMSELLA
Official Title
A Double-Blind, Sham Controlled Prospective Pilot Study of Urinary Stress Incontinence and Urgency in Women After 6 Treatments With HIFEM Technology (BTL EMSELLA)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 11, 2019 (Actual)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
June 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
San Diego Sexual Medicine

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this prospective study is to examine the safety and efficacy of high intensity focused electromagnetic (HIFEM) technology for the treatment of women with stress urinary incontinence (SUI), urge incontinence (UI) and mixed stress urinary and urge incontinence (MUI), looking at any potential sexual health benefits that may be concomitantly achieved from this treatment.
Detailed Description
This is a blinded study to be conducted at San Diego Sexual Medicine in San Diego, CA. Participants meeting inclusion and exclusion criteria will receive one treatment cycle of active treatment or sham. The device will be equipped with 3 protocols in addition to the standard protocol, two of which are identical to the standard protocol (for active treatment) and one of which does not deliver HIFEM (for sham treatment). The active treatment arm consists of 6 treatments, 2 per week, with at least one day in between. Follow-up visits will occur at 4 weeks and 12 weeks after the last treatment. Unblinding will take place at the 12 week follow up visit, and subjects assigned to the sham arm will be crossed over to active treatment, beginning their first treatment on that day, completing 6 treatments and 2 follow up visits. Once unblinded the subject will be treated with the standard protocol of the device. After the informed consent is signed, and inclusion and exclusion criteria completed, participants will complete validated questionnaires and undergo a baseline physical therapy assessment of pelvic floor muscle strength.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stress Urinary Incontinence, Urge Incontinence
Keywords
incontinence, stress urgency incontinence, urge incontinence, EMSELLA

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Active and sham arms 2:1 run parallel. Upon completion, sham patients repeat visits with open label treatment.
Masking
ParticipantCare ProviderInvestigator
Masking Description
Three blinded protocols available on the device, so care provider will not know to which treatment subject is randomized. Active treatment is not blinded for use in open label portion of study.
Allocation
Randomized
Enrollment
21 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active EMSELLA treatment
Arm Type
Active Comparator
Arm Description
6 treatments on the BTL EMSELLA using a device protocol that is active HIFEM technology
Arm Title
Sham EMSELLA treatment
Arm Type
Sham Comparator
Arm Description
6 treatments on the BTL EMSELLA with a sham device protocol that provides some sensation without active HIFEM technology
Intervention Type
Device
Intervention Name(s)
BTL EMSELLA
Intervention Description
High intensity focused electromagnetic (HIFEM) technology induces deep pelvic floor muscle contractions designed to deliver the equivalent of 11,200 Kegel exercises over 28 minutes.
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events
Description
Serious adverse events and adverse events related to device will be collected to assess safety
Time Frame
Up to 18 weeks for active arm; up to 32 weeks for sham arm
Title
QUID (Questionnaire for Urinary Incontinence Diagnosis)
Description
Change in Questionnaire for Urinary Incontinence Diagnosis (QUID) from pre-treatment to each follow up visit
Time Frame
At screen, 4 weeks, 6 weeks, 10 weeks, 18 weeks; for sham arm additionally at 20 weeks, 24 weeks, 32 weeks
Secondary Outcome Measure Information:
Title
FSFI (Female Sexual Function Index) Orgasm Domain
Description
Change in Orgasm Domain of the Female Sexual Function Index from pre-treatment to follow up visits. Range is 0-6 with higher the results representing better outcome
Time Frame
At screen, 4 weeks, 6 weeks, 10 weeks, 18 weeks; for sham arm additionally at 20 weeks, 24 weeks, 32 weeks
Title
FSFI (Female Sexual Function Index)
Description
Change in total score of the Female Sexual Function Index from pre-treatment to follow up visits. Range is 2-36, with higher results representing better the outcome, and 26.55 and above signifying no sexual dysfunction
Time Frame
At screen, 4 weeks, 6 weeks, 10 weeks, 18 weeks; for sham arm additionally at 20 weeks, 24 weeks, 32 weeks
Title
FSDS-DAO (Female Sexual Distress Score-Desire, Arousal, Orgasm)
Description
Change in total score of the Female Sexual Distress Score-Desire, Arousal, Orgasm from pre-treatment to follow up visits. Range is from 0-60 with lower results representing the better outcome.
Time Frame
At screen, 4 weeks, 6 weeks, 10 weeks, 18 weeks; for sham arm additionally at 20 weeks, 24 weeks, 32 weeks
Title
ISCI (Interstitial Cystitis Symptoms Index )/ICPI (Interstitial Cystitis Problem Index)
Description
Change in total score of the ICSI/ICPI Questionnaire from pre-treatment to follow up visits. Range is 0-35, with lower results representing the better the outcome.
Time Frame
At screen, 4 weeks, 6 weeks, 10 weeks, 18 weeks; for sham arm additionally at 20 weeks, 24 weeks, 32 weeks
Title
Modified Oxford Scale measuring pelvic floor strength
Description
Change in degree of force based on the modified Oxford scale measuring pelvic floor muscle strength from pre-treatment to follow up visits. Scale is a single recording from 0 (lack of muscle response) to 5 (strong contraction, firm compression) with higher results representing the better the outcome.
Time Frame
At screen, 10 weeks, 18 weeks; for sham arm additionally at 24 weeks, 32 weeks
Other Pre-specified Outcome Measures:
Title
PGI-I (Patient global impression of improvement)
Description
Patient global impression of improvement, range 2-14, with higher results representing the better outcome
Time Frame
At 18 weeks; for sham arm additionally at 32 weeks

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
cis-gender woman
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject provides written informed consent and HIPAA authorization before any study procedures are conducted; Subject is female; Subject is aged 21-80 years; Subject has a body mass index (BMI) < 37 kg/m2; Subject has stress urinary incontinence, urge incontinence, or mixed urinary incontinence as determined by the QUID; Subject is currently sexually active and willing to continue sexual activity throughout the study; Subject is willing to continue level of core exercise currently being performed or not performed during the study (e.g. gym, Pilates, yoga); Subject is willing to maintain her current prescription and over the counter medications throughout the study without changing them; Subject agrees to comply with the study procedures and visits. Exclusion Criteria: Subject has used the BTL EMSELLA device previously; Subject has any significant pelvic organ prolapse; Subject has clinically significant findings on physical examination; Subject has any chronic medical condition (e.g. neurologic disorder) or psychologic disorder that the Principal Investigator feels makes her ineligible for the study; Subject is unwilling to maintain current level of exercise throughout the study; Subject has been diagnosed with overactive bladder or interstitial cystitis; Subject experiences bladder pain or scores above 0 on the pain questions on the O'Leary/Sant Voiding and Pain Indices (ICSI/ICPI); Subject experiences pain with sexual activity Subject answers anything other than "almost never or never" or "a few times" on pain questions 17 or 18 of the Female Sexual Function Index (FSFI) Subject answers anything other than "very low or none at all" or "low" on pain questions 19 of the (FSFI) Subject planning to have surgery during the study; Subject has untreated malignancy; Subject is pregnant, planning to get pregnant or within 3 months postpartum; Subject has a pacemaker; Subject has and implant or IUD containing metal (e.g. copper 7); Subject has piercing between the waist and knees and is not willing to remove it before each treatment; Subject has a history of substance abuse within 12 months prior, or consuming > 14 alcoholic drinks per week; Subject has received an investigational drug within 30 days prior to signing consent; Subject has any condition or exhibits behavior that indicates to the Principal Investigator that the Subject is unlikely to be compliant with study procedures and visits.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Clinical Research Manager
Phone
619-265-8865
Email
information@sdsm.info
First Name & Middle Initial & Last Name or Official Title & Degree
Wendy Ramirez, AB
Phone
6192658865
Email
wramirez@sdsm.info
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sue W Goldstein, BA
Organizational Affiliation
Clinical Research Manager
Official's Role
Study Director
Facility Information:
Facility Name
San Diego Sexual Medicine
City
San Diego
State/Province
California
ZIP/Postal Code
92120
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clinical Research Manager
Phone
619-265-8865
Email
information@sdsm.info
First Name & Middle Initial & Last Name & Degree
Wendy Ramirez, AB
Phone
6192658865
Email
wramirez@sdsm.info
First Name & Middle Initial & Last Name & Degree
Irwin Goldstein, MD
First Name & Middle Initial & Last Name & Degree
Julea N Minton, NP-C
First Name & Middle Initial & Last Name & Degree
Catherine L Gagnon, FNP-BC

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
15017223
Citation
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Results Reference
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17694560
Citation
Coletti D, Teodori L, Albertini MC, Rocchi M, Pristera A, Fini M, Molinaro M, Adamo S. Static magnetic fields enhance skeletal muscle differentiation in vitro by improving myoblast alignment. Cytometry A. 2007 Oct;71(10):846-56. doi: 10.1002/cyto.a.20447.
Results Reference
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PubMed Identifier
10367460
Citation
Ishikawa N, Suda S, Sasaki T, Yamanishi T, Hosaka H, Yasuda K, Ito H. Development of a non-invasive treatment system for urinary incontinence using a functional continuous magnetic stimulator (FCMS). Med Biol Eng Comput. 1998 Nov;36(6):704-10. doi: 10.1007/BF02518872.
Results Reference
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PubMed Identifier
24320971
Citation
Ostrovidov S, Hosseini V, Ahadian S, Fujie T, Parthiban SP, Ramalingam M, Bae H, Kaji H, Khademhosseini A. Skeletal muscle tissue engineering: methods to form skeletal myotubes and their applications. Tissue Eng Part B Rev. 2014 Oct;20(5):403-36. doi: 10.1089/ten.TEB.2013.0534. Epub 2014 Feb 24.
Results Reference
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PubMed Identifier
26202157
Citation
Stolting MN, Arnold AS, Haralampieva D, Handschin C, Sulser T, Eberli D. Magnetic stimulation supports muscle and nerve regeneration after trauma in mice. Muscle Nerve. 2016 Apr;53(4):598-607. doi: 10.1002/mus.24780.
Results Reference
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PubMed Identifier
11795642
Citation
Truijen G, Wyndaele JJ, Weyler J. Conservative treatment of stress urinary incontinence in women: who will benefit? Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):386-90. doi: 10.1007/s001920170018.
Results Reference
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PubMed Identifier
21817123
Citation
Wallis MC, Davies EA, Thalib L, Griffiths S. Pelvic static magnetic stimulation to control urinary incontinence in older women: a randomized controlled trial. Clin Med Res. 2012 Feb;10(1):7-14. doi: 10.3121/cmr.2011.1008. Epub 2011 Aug 4.
Results Reference
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PubMed Identifier
10647653
Citation
Yamanishi T, Yasuda K, Suda S, Ishikawa N, Sakakibara R, Hattori T. Effect of functional continuous magnetic stimulation for urinary incontinence. J Urol. 2000 Feb;163(2):456-9.
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PubMed Identifier
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Citation
Yamanishi T, Yasuda K, Sakakibara R, Hattori T, Ito H, Murakami S. Pelvic floor electrical stimulation in the treatment of stress incontinence: an investigational study and a placebo controlled double-blind trial. J Urol. 1997 Dec;158(6):2127-31. doi: 10.1016/s0022-5347(01)68176-x.
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Urinary Stress Incontinence and Urgency in Women With EMSELLA

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