Waterjet Ablation Therapy for Endoscopic Resection of Prostate Tissue II (WATERII)
Primary Purpose
Benign Prostatic Hyperplasia (BPH)
Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Aquablation
Sponsored by
About this trial
This is an interventional treatment trial for Benign Prostatic Hyperplasia (BPH) focused on measuring Lower Urinary Tract Symptoms (LUTS), AQUABEAM, Aquablation, Benign Prostatic Hyperplasia (BPH)
Eligibility Criteria
Inclusion Criteria:
- Male age 45-80 years.
- Subject has diagnosis of lower urinary tract symptoms due to benign prostatic enlargement causing bladder outlet obstruction.
- Subject has an IPSS score greater than or equal to 12.
- Maximum urinary flow rate (Qmax) less than 15mL/s.
- Serum creatinine < 2 mg/dL within 30 days of surgery.
- History of inadequate or failed response, contraindication, or refusal to medical therapy.
- Prostate size ≥ 80 mL and ≤ 150 mL as measured by TRUS.
- Patient is mentally capable and willing to sign a study-specific informed consent form.
Exclusion Criteria:
- BMI ≥ 42.
- Patients unable to stop anticoagulants, antiplatelet agents, or non-steroidal anti-inflammatory agents (NSAIDs, including aspirin greater or equal to 100mg) prior to treatment per standard of care.
- Participants using systemic immune-suppressants including corticosteroids (except inhalants); unable to withhold non-steroidal anti-inflammatory agents (NSAIDs, including aspirin) prior to treatment per standard or care except for low dose aspirin (e.g. less than or equal to 100mg).
- Contraindication to both general and spinal anesthesia.
- Any severe illness that would prevent complete study participation or confound study results.
- History of prostate cancer or current/suspected bladder cancer. Prostate cancer should be ruled out before participation to the satisfaction of the investigator if PSA is above acceptable thresholds.
- History of actively treated bladder cancer within the past two (2) years.
- Clinically significant bladder calculus or bladder diverticulum (e.g., pouch size >20% of full bladder size).
- Active infection, including urinary tract infection or prostatitis.
- Urinary catheter use daily for 90 or more days consecutively.
- Previous urinary tract surgery such as e.g. urinary diversion, artificial urinary sphincter or penile prosthesis.
- Ever been diagnosed with a clinically significant urethral stricture or meatal stenosis, or bladder neck contracture.
- Known damage to external urinary sphincter.
- Has had an open heart surgery, or cardiac arrest < 180 days prior to the date of informed consent.
- Participants using anticholinergics specifically for bladder problems. Use of medications with anticholinergic properties is allowable provided the patient does not have documented adverse urinary side effects from these medications.
- Subject is unwilling to accept a transfusion should one be required.
Sites / Locations
- Mayo Clinic Arizona
- Tibor Rubin VA Medical Center
- University of Southern California, Institute of Urology
- San Diego Clinical Trials
- Indiana University School of Medicine
- Adult & Pediatrics Urology
- Albany Medical College
- Icahn School of Medicine at Mount Sinai
- Wake Forest School of Medicine
- UT Southwestern Medical Center
- University of Vermont
- Virginia Urology
- Urology of Virginia
- University of British Columbia
- University of Toronto-University Health Network
- Université de Montréal
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Aquablation procedure
Arm Description
Outcomes
Primary Outcome Measures
Incidence of Clavien-Dindo Adverse Events (Percentage of Participants) Through 3 Months Post Treatment
The percentage of subjects with adverse events rated as probably or definitely related to the study procedure classified as Clavien-Dindo Grade 2 or higher or any Grade 1 event resulting in persistent disability (e.g. ejaculatory disorder or erectile dysfunction) evidenced through 3 months post treatment.
Change in Total International Prostate Symptom Score (IPSS) Score at 3 Months as Compared to Baseline
The change in total IPSS score at 3 months as compared to baseline.
The objective of the International Prostate Symptom Score (IPSS) is to capture the severity of urinary symptoms related to benign prostatic hyperplasia IPSS ranges from 0 to 35. A higher score indicates a worse outcome.
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03123250
Brief Title
Waterjet Ablation Therapy for Endoscopic Resection of Prostate Tissue II
Acronym
WATERII
Official Title
Waterjet Ablation Therapy for Endoscopic Resection of Prostate Tissue II
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
August 14, 2017 (Actual)
Primary Completion Date
March 27, 2018 (Actual)
Study Completion Date
December 20, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
PROCEPT BioRobotics
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
Single-arm, interventional pivotal clinical trial collecting patient data from use of the AQUABEAM System, a personalized image-guided waterjet resection system that utilizes a high-velocity saline stream to resect and remove prostate tissue in males suffering from Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) with prostate volumes between 80 mL and 150 mL. The primary endpoints for safety and effectiveness will be measured at 3 months post-treatment. Treated subjects will be followed out to 60 months to collect long-term clinical data.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Benign Prostatic Hyperplasia (BPH)
Keywords
Lower Urinary Tract Symptoms (LUTS), AQUABEAM, Aquablation, Benign Prostatic Hyperplasia (BPH)
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
101 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Aquablation procedure
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
Aquablation
Intervention Description
The procedure is performed with the AquaBeam System. It is designed to utilize a high-velocity sterile saline waterjet as the cutting medium, which is projected through a nozzle positioned within the prostatic urethra. The Aquablation procedure integrates real-time ultrasound imaging with a robotically executed surgeon guided high-velocity waterjet to resect prostate tissue.
Primary Outcome Measure Information:
Title
Incidence of Clavien-Dindo Adverse Events (Percentage of Participants) Through 3 Months Post Treatment
Description
The percentage of subjects with adverse events rated as probably or definitely related to the study procedure classified as Clavien-Dindo Grade 2 or higher or any Grade 1 event resulting in persistent disability (e.g. ejaculatory disorder or erectile dysfunction) evidenced through 3 months post treatment.
Time Frame
3 months post-treatment
Title
Change in Total International Prostate Symptom Score (IPSS) Score at 3 Months as Compared to Baseline
Description
The change in total IPSS score at 3 months as compared to baseline.
The objective of the International Prostate Symptom Score (IPSS) is to capture the severity of urinary symptoms related to benign prostatic hyperplasia IPSS ranges from 0 to 35. A higher score indicates a worse outcome.
Time Frame
3 months post-treatment
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male age 45-80 years.
Subject has diagnosis of lower urinary tract symptoms due to benign prostatic enlargement causing bladder outlet obstruction.
Subject has an IPSS score greater than or equal to 12.
Maximum urinary flow rate (Qmax) less than 15mL/s.
Serum creatinine < 2 mg/dL within 30 days of surgery.
History of inadequate or failed response, contraindication, or refusal to medical therapy.
Prostate size ≥ 80 mL and ≤ 150 mL as measured by TRUS.
Patient is mentally capable and willing to sign a study-specific informed consent form.
Exclusion Criteria:
BMI ≥ 42.
Patients unable to stop anticoagulants, antiplatelet agents, or non-steroidal anti-inflammatory agents (NSAIDs, including aspirin greater or equal to 100mg) prior to treatment per standard of care.
Participants using systemic immune-suppressants including corticosteroids (except inhalants); unable to withhold non-steroidal anti-inflammatory agents (NSAIDs, including aspirin) prior to treatment per standard or care except for low dose aspirin (e.g. less than or equal to 100mg).
Contraindication to both general and spinal anesthesia.
Any severe illness that would prevent complete study participation or confound study results.
History of prostate cancer or current/suspected bladder cancer. Prostate cancer should be ruled out before participation to the satisfaction of the investigator if PSA is above acceptable thresholds.
History of actively treated bladder cancer within the past two (2) years.
Clinically significant bladder calculus or bladder diverticulum (e.g., pouch size >20% of full bladder size).
Active infection, including urinary tract infection or prostatitis.
Urinary catheter use daily for 90 or more days consecutively.
Previous urinary tract surgery such as e.g. urinary diversion, artificial urinary sphincter or penile prosthesis.
Ever been diagnosed with a clinically significant urethral stricture or meatal stenosis, or bladder neck contracture.
Known damage to external urinary sphincter.
Has had an open heart surgery, or cardiac arrest < 180 days prior to the date of informed consent.
Participants using anticholinergics specifically for bladder problems. Use of medications with anticholinergic properties is allowable provided the patient does not have documented adverse urinary side effects from these medications.
Subject is unwilling to accept a transfusion should one be required.
Facility Information:
Facility Name
Mayo Clinic Arizona
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
Tibor Rubin VA Medical Center
City
Long Beach
State/Province
California
ZIP/Postal Code
90822
Country
United States
Facility Name
University of Southern California, Institute of Urology
City
Los Angeles
State/Province
California
ZIP/Postal Code
90089
Country
United States
Facility Name
San Diego Clinical Trials
City
San Diego
State/Province
California
ZIP/Postal Code
92120
Country
United States
Facility Name
Indiana University School of Medicine
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Adult & Pediatrics Urology
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68114
Country
United States
Facility Name
Albany Medical College
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Wake Forest School of Medicine
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-9110
Country
United States
Facility Name
University of Vermont
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05054
Country
United States
Facility Name
Virginia Urology
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23235
Country
United States
Facility Name
Urology of Virginia
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23462
Country
United States
Facility Name
University of British Columbia
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 1M9
Country
Canada
Facility Name
University of Toronto-University Health Network
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 1Z6
Country
Canada
Facility Name
Université de Montréal
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2X 0A9
Country
Canada
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
37115632
Citation
Bhojani N, Bidair M, Kramolowsky E, Desai M, Doumanian L, Zorn KC, Elterman D, Kaufman RP Jr, Eure G, Badlani G, Plante M, Uchio E, Gin G, Paterson R, So A, Roehrborn C, Motola J, Kaplan S, Humphreys M. Aquablation Therapy in Large Prostates (80-150 mL) for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Final WATER II 5-Year Clinical Trial Results. J Urol. 2023 Jul;210(1):143-153. doi: 10.1097/JU.0000000000003483. Epub 2023 Apr 28.
Results Reference
background
PubMed Identifier
30734990
Citation
Desai M, Bidair M, Zorn KC, Trainer A, Arther A, Kramolowsky E, Doumanian L, Elterman D, Kaufman RP Jr, Lingeman J, Krambeck A, Eure G, Badlani G, Plante M, Uchio E, Gin G, Goldenberg L, Paterson R, So A, Humphreys M, Roehrborn C, Kaplan S, Motola J, Bhojani N. Aquablation for benign prostatic hyperplasia in large prostates (80-150 mL): 6-month results from the WATER II trial. BJU Int. 2019 Aug;124(2):321-328. doi: 10.1111/bju.14703. Epub 2019 Mar 29.
Results Reference
background
PubMed Identifier
32333733
Citation
Desai M, Bidair M, Bhojani N, Trainer A, Arther A, Kramolowsky E, Doumanian L, Elterman D, Kaufman RP Jr, Lingeman J, Krambeck A, Eure G, Badlani G, Plante M, Uchio E, Gin G, Goldenberg L, Paterson R, So A, Humphreys MR, Roehrborn CG, Kaplan S, Motola J, Zorn KC. Aquablation for benign prostatic hyperplasia in large prostates (80-150 cc): 2-year results. Can J Urol. 2020 Apr;27(2):10147-10153.
Results Reference
background
PubMed Identifier
29694702
Citation
Desai M, Bidair M, Bhojani N, Trainer A, Arther A, Kramolowsky E, Doumanian L, Elterman D, Kaufman RP Jr, Lingeman J, Krambeck A, Eure G, Badlani G, Plante M, Uchio E, Gin G, Goldenberg L, Paterson R, So A, Humphreys M, Roehrborn C, Kaplan S, Motola J, Zorn KC. WATER II (80-150 mL) procedural outcomes. BJU Int. 2019 Jan;123(1):106-112. doi: 10.1111/bju.14360. Epub 2018 Jun 10.
Results Reference
background
PubMed Identifier
31059728
Citation
Bhojani N, Bidair M, Zorn KC, Trainer A, Arther A, Kramolowsky E, Doumanian L, Elterman D, Kaufman RP, Lingeman J, Krambeck A, Eure G, Badlani G, Plante M, Uchio E, Gin G, Goldenberg L, Paterson R, So A, Humphreys M, Kaplan S, Motola J, Desai M, Roehrborn C. Aquablation for Benign Prostatic Hyperplasia in Large Prostates (80-150 cc): 1-Year Results. Urology. 2019 Jul;129:1-7. doi: 10.1016/j.urology.2019.04.029. Epub 2019 May 3.
Results Reference
background
PubMed Identifier
29873008
Citation
Chughtai B, Thomas D. Pooled Aquablation Results for American Men with Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia in Large Prostates (60-150 cc). Adv Ther. 2018 Jun;35(6):832-838. doi: 10.1007/s12325-018-0722-0. Epub 2018 Jun 5.
Results Reference
derived
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Waterjet Ablation Therapy for Endoscopic Resection of Prostate Tissue II
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