Overactive Bladder Clinical Trial
Official title:
Percutaneous Tibial Nerve Stimulation vs. Transcutaneous Electrical Nerve Stimulation for Overactive Bladder: A Randomized Trial
The purpose of this study is to determine whether transcutaneous sacral nerve stimulation (TENS SNS) versus percutaneous tibial nerve stimulation (PTNS) is a more effective therapeutic option for subjects with idiopathic overactive bladder (OAB) who have failed conventional therapy. Our primary hypothesis is that TENS therapy is a more effective treatment option due to ease of use and improved subject compliance with this form of therapy.
Status | Enrolling by invitation |
Enrollment | 114 |
Est. completion date | December 2017 |
Est. primary completion date | March 2017 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Female - Age >18 years - Predominant complaint urge urinary incontinence (3 or more episodes per week) OR overactive bladder (8 or more voids per day, and/or 2 or more voids per night) - Failed trial of conservative therapy (bladder training, fluid modification, diet modification, caffeine restriction, pelvic floor training) - Failed trial of anticholinergic either due to inability to take the medication, adverse reaction to medication, or no improvement on medication - Willing and mentally competent to participate in study - Willing to complete study questionnaires - No contraindications to undergoing PTNS or TENS therapy Exclusion Criteria: - Age < 18 years - Presence of urinary fistula - Male. (Males will be excluded because of the different etiology of overactive bladder for males which is primarily caused by prostate problems for men versus the primarily idiopathic cause in women). - Recurrent or current urinary tract infection (5 or more infections in the last 12 months) - Bladder stones - Bladder cancer or suspected bladder cancer - Hematuria - Pregnancy or planning to become pregnant during the study (urine pregnancy test will be administered to those who are premenopausal and who have not had a hysterectomy) - Central or peripheral neurologic disorders such as Multiple Sclerosis, Parkinson's disease, spina bifida, or other spinal cord lesion - Metal implants such as pacemaker, implantable defibrillator, or metal implants where PTNS or TENS device needs to be placed (sacrum or ankle/leg). - Uncontrolled diabetes - Diabetes with peripheral nerve involvement - On anticoagulants - Current use of anticholinergics or use within the last 4 weeks - Current use of botox bladder injections or bladder botox injection within the last year - Current use of interstim therapy or currently implanted interstim device or leads - Bladder outlet obstruction - Urinary retention or gastric retention - Painful Bladder Syndrome/Interstitial Cystitis |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Walter Reed National Military Medical Center | Bethesda | Maryland |
United States | Fort Belvoir Community Hospital | Fort Belvoir | Virginia |
United States | Portsmouth Naval Hospital | Portsmouth | Virginia |
Lead Sponsor | Collaborator |
---|---|
Walter Reed National Military Medical Center | International Urogynecological Association (Grant), Section on Women's Health (Grant) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percutaneous Tibial Nerve Stimulation vs. Transcutaneous Electrical Nerve Stimulation for Overactive Bladder: A Randomized Trial | The primary response variable is 'success' at 1 year, defined as a 50% or more reduction in the total number of incontinence episodes, or a 25% or more reduction in number of daily or nightly voids AND that the patient continues to use the therapy at one year. Therefore primary response is: 50% reduction in incontinence, OR 25% reduction in nightly voids AND continued use of therapy at one year. | 2 years | No |
Secondary | Percutaneous Tibial Nerve Stimulation vs. Transcutaneous Electrical Nerve Stimulation for Overactive Bladder: A Randomized Trial | Participant compliance defined as 75% adherence to the recommended use for each device. | 2 years | No |
Secondary | Percutaneous Tibial Nerve Stimulation vs. Transcutaneous Electrical Nerve Stimulation for Overactive Bladder: A Randomized Trial | Changes in the OAB-q (Overactive Bladder Questionnaire), the PFDI (Pelvic Floor Distress Inventory), and the FSFI (Female Sexual Function Index) | 2 Years | No |
Secondary | Percutaneous Tibial Nerve Stimulation vs. Transcutaneous Electrical Nerve Stimulation for Overactive Bladder: A Randomized Trial | Changes in urodynamic studies (i.e. bladder capacity, uroflow rate, post-void residual). | 2 Years | No |
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