Study of Overactive Bladder in Women With Prolapse - Full Text View

Purpose

Pelvic organ prolapse (POP) is a common problem. Symptoms of overactive bladder (OAB) are present in approximately 50% of patients with POP. For many women the accompanying symptoms of OAB are an important reason for seeking help for their POP. Surgical repair of prolapse may improve OAB complaints. Persisting or de novo OAB symptoms are strongly correlated with dissatisfaction with the final results of an operation for POP.

The primary aim of this research project is to investigate the difference in prevalence (i.e. improvement) of OAB and bothersome OAB symptoms at 6 and 12 months after POP repair surgery. The secondary objectives are to determine changes in bladder function at 6 and 12 months after surgery and to identify predictive factors for persistence, disappearance or de novo symptoms of OAB after POP surgery.

Women who present with POP and who will undergo surgical treatment will be evaluated at baseline before their surgery and will be followed for the duration of one year after surgery.

Condition	Intervention
Urinary Bladder, Overactive Pelvic Organ Prolapse	Other: Pre- and postoperative evaluations

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Prevalence of Overactive Bladder (OAB) in Patients With Pelvic Organ Prolapse (POP) and Predictors of Symptoms of OAB After Surgical Correction of POP

Resource links provided by NLM:

MedlinePlus related topics: Pelvic Support Problems

U.S. FDA Resources

Further study details as provided by Radboud University:

Primary Outcome Measures:

The change from baseline in prevalence of OAB as measured by bladder diary and validated disease specific questionnaires at 6 months [ Time Frame: At baseline before surgery and at 6 months after surgery ] [ Designated as safety issue: No ]
The change from baseline of bothersome OAB symptoms as measured by bladder diary and validated disease specific questionnaires at 6 months [ Time Frame: At baseline before surgery and at 6 months after surgery ] [ Designated as safety issue: No ]
The bother of OAB symptoms, measured by validated disease specific questionnaires, will be presented by scores that reflect the degree of severity of the voiding dysfunction. The presence of bothersome OAB symptoms will be dichotomized in patients with symptoms and moderate to severe bother (symptomatic) and patients with absence of symptoms or with only little or no bother (asymptomatic).
The change from baseline in prevalence of OAB as measured by bladder diary and validated disease specific questionnaires at 12 months [ Time Frame: At baseline before surgery and at 12 months after surgery ] [ Designated as safety issue: No ]
The change from baseline of bothersome OAB symptoms as measured by bladder diary and validated disease specific questionnaires at 12 months [ Time Frame: At baseline before surgery and at 12 months after surgery ] [ Designated as safety issue: No ]
The bother of OAB symptoms, measured by validated disease specific questionnaires, will be presented by scores that reflect the degree of severity of the voiding dysfunction. The presence of bothersome OAB symptoms will be dichotomized in patients with symptoms and moderate to severe bother (symptomatic) and patients with absence of symptoms or with only little or no bother (asymptomatic).

Secondary Outcome Measures:

Change from baseline in outcomes of urodynamic studies (presence of detrusor overactivity (DO), bladder outflow obstruction (BOO)) at 12 months [ Time Frame: At baseline before surgery and at 12 months after surgery ] [ Designated as safety issue: Yes ]
Change from baseline in POP-Q stage at 6 and 12 months [ Time Frame: At baseline before surgery, at 6 and 12 months after surgery ] [ Designated as safety issue: No ]
Change from baseline in outcomes of ultrasound assessment (bladder wall thickness, bladder neck descent, retrovesical angle) at 6 and 12 months [ Time Frame: At baseline before surgery, at 6 and 12 months after surgery ] [ Designated as safety issue: No ]
Cystoscopic assessment of trabeculation [ Time Frame: At time of surgery ] [ Designated as safety issue: Yes ]
Change from baseline in concentration of urinary biomarkers at 12 months [ Time Frame: At baseline before surgery and at 12 months after surgery ] [ Designated as safety issue: No ]
Concentration of urinary biomarkers: nerve growth factor (NGF), prostaglandin E2 (PGE2) and adenosine triphosphate (ATP) levels in urine normalized against creatinine concentration.

Biospecimen Retention: Samples With DNA

Urine

Estimated Enrollment:	100
Study Start Date:	February 2012
Estimated Study Completion Date:	December 2014
Estimated Primary Completion Date:	June 2014 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
POP surgery All women who present with POP at the outpatient clinic of our centre and who will undergo prolapse repair surgery will be asked informed consent for participation in this study	Other: Pre- and postoperative evaluations At baseline before surgery and at 6 and 12 months after surgery: questionnaires, bladder diary, pelvic examination with additional ultrasound (one extra outpatient clinic visit at 6 months compared to standard care). At baseline before surgery and at 12 months after surgery: urodynamics with additional urine sampling (one extra outpatient clinic visit at 12 months compared to standard care). At time of surgery: additional cystoscopy.

Groups/Cohorts

Assigned Interventions

POP surgery

All women who present with POP at the outpatient clinic of our centre and who will undergo prolapse repair surgery will be asked informed consent for participation in this study

Other: Pre- and postoperative evaluations

At baseline before surgery and at 6 and 12 months after surgery: questionnaires, bladder diary, pelvic examination with additional ultrasound (one extra outpatient clinic visit at 6 months compared to standard care).

At baseline before surgery and at 12 months after surgery: urodynamics with additional urine sampling (one extra outpatient clinic visit at 12 months compared to standard care).

At time of surgery: additional cystoscopy.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Female
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

All women who present with POP at the outpatient clinic of our centre and who will undergo prolapse repair surgery will be asked informed consent for participation in this study.

Criteria

Inclusion Criteria:

Female patients, age 18 or greater, with a pelvic organ prolapse stage II to IV as defined by the POP-Q system
Patient is a candidate for prolapse repair surgery (as based on history and physical examination)
Patient is capable to fill out bladder diaries and questionnaires and understands the Dutch written and spoken language

Exclusion Criteria:

Patients who currently use anticholinergic medication
Patients with neurological causes of OAB
Patients who are pregnant
Patients with a history of cancer in the pelvic region, treated with radiotherapy or surgery

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01540214

Contacts

Contact: Myrthe M Tijdink, MD	+31-(0)24-3614726	m.tijdink@uro.umcn.nl
Contact: Mark E Vierhout, MD,PhD	+31-(0)24-3614726	m.vierhout@obgyn.umcn.nl

Locations

Netherlands
Radboud University Nijmegen Medical Centre	Recruiting
Nijmegen, Netherlands, 6500 HB
Contact: Myrthe M Tijdink, MD +31-(0)24-3614726 m.tijdink@uro.umcn.nl
Principal Investigator: Myrthe M Tijdink, MD

Sponsors and Collaborators

Radboud University

Astellas Pharma Inc

Continentie Stichting Nederland (Continence Foundation The Netherlands)

Investigators

Principal Investigator:	Mark E Vierhout, MD, PhD	Radboud University
Principal Investigator:	John PF Heesakkers, MD, PhD	Radboud University
Principal Investigator:	Myrthe M Tijdink, MD	Radboud University

More Information

No publications provided

Responsible Party:	Radboud University
ClinicalTrials.gov Identifier:	NCT01540214 History of Changes
Other Study ID Numbers:	2011/456
Study First Received:	February 10, 2012
Last Updated:	January 4, 2013
Health Authority:	Netherlands: The Central Committee on Research Involving Human Subjects (CCMO)

Keywords provided by Radboud University:

Urinary Bladder, Overactive
Pelvic Organ Prolapse
Gynecologic Surgical Procedures
Urodynamics

Additional relevant MeSH terms:

Prolapse
Pelvic Organ Prolapse
Urinary Bladder, Overactive
Pathological Conditions, Anatomical

Urinary Bladder Diseases
Urologic Diseases
Urological Manifestations
Signs and Symptoms

ClinicalTrials.gov processed this record on May 16, 2013

Study of Overactive Bladder in Women With Prolapse (SOAP)