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Standardization of Cough Stress Test

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ClinicalTrials.gov Identifier: NCT02742584
Recruitment Status : Completed
First Posted : April 19, 2016
Last Update Posted : April 21, 2016
Sponsor:
Information provided by (Responsible Party):
Joseph Henderson, University Hospitals Cleveland Medical Center

Brief Summary:
This is a multicenter, prospective, randomized comparative study in which patients are randomized to one of four different bladder volumes and a Cough Stress Test (CST) is performed in both the standing and sitting positions. The goal is to assess the agreement of each CST method with both urodynamics diagnosis of Stress Urinary Incontinence (SUI) and the 24-hour pad test. The primary outcome is to determine what CST method best correlated with either test in the diagnosis of SUI.

Condition or disease Intervention/treatment Phase
Stress Urinary Incontinence Procedure: Cough Stress Test Not Applicable

Detailed Description:

This multicenter, prospective randomized study is approved by the Institutional Review Boards at both the University Hospitals Case Medical Center, Cleveland, OH, USA and MetroHealth Hospital, Cleveland, OH, USA (Identifiers 07-11-37 and FWA00003938, respectively). Adult women who presented to the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) outpatient clinics at both the University Hospitals Case Medical Center and MetroHealth Hospital with symptoms of stress, urge, or mixed urinary incontinence and who were recommended by the evaluating staff to undergo urodynamic studies (UDS) are eligible. The staff physician will approach the patient for participation in this study after the standard clinic visit is completed and the initial diagnosis is made. A research coordinator will then explain the study and obtain informed consent if the patient agrees to participate. The patient will then be given instructions for a 24 hour pad test and standardized pads to use. The patient will also be given instructions for a three day voiding diary along with routine instruction regarding the urodynamic procedure. The patient will be asked to perform the 24 hour pad test the day prior to the UDS appointment. The three day voiding diary will be performed during a typical and sequential three day period during the week prior to the UDS. Patients will then asked to bring these items to the UDS appointment.

During the initial appointment with the study coordinator, patients will be randomized to 4 groups (A, B, C, and D). Patients in group A will be scheduled to undergo Cough Stress Test (CST) with a comfortably full bladder. This will be subjectively reported by the patient. Patients in group B will be scheduled to undergo CST with an empty bladder after straight catheterization. Group C patients will be scheduled to undergo CST with a bladder infused with 200 cc of saline. Patients in group D will be scheduled to undergo CST with the bladder filled to half functional capacity as determined from the largest voided volume recorded in the patient's voiding diary. CST will be performed in the standing and sitting position for each patient in each of the above groups. The sequence of performing the standing and sitting CST will be randomly assigned for each patient.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 140 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: A Randomized Comparative Study Correlating Cough Stress Test With Urodynamics And 24 Hour Pad Test In the Evaluation of Stress Urinary Incontinence
Study Start Date : August 2012
Actual Primary Completion Date : March 2015
Actual Study Completion Date : March 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Group A
Cough Stress Test with a comfortably full bladder.
Procedure: Cough Stress Test
Varying bladder volumes during cough stress test.

Experimental: Group B
Cough Stress Test with an empty bladder after straight catheterization.
Procedure: Cough Stress Test
Varying bladder volumes during cough stress test.

Experimental: Group C
Cough Stress Test with a bladder infused with 200 cc of saline.
Procedure: Cough Stress Test
Varying bladder volumes during cough stress test.

Experimental: Group D
Cough Stress Test with the bladder filled to half functional capacity as determined from the largest voided volume recorded in the patient's voiding diary.
Procedure: Cough Stress Test
Varying bladder volumes during cough stress test.




Primary Outcome Measures :
  1. Correlation of cough stress test with urodynamics [ Time Frame: 30 minutes ]
    To define how different accepted cough stress test methods correlated with urodynamics in the evaluation of stress urinary incontinence.


Secondary Outcome Measures :
  1. 24hour pad weight [ Time Frame: 24 hours ]
    To assess if there was any benefit to performing a 24 hour pad test with or without the different cough stress test modalities.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • symptoms of urinary incontinence as a chief complaint or as the reason for scheduling the clinic visit, and who were to be scheduled to undergo urodynamic (UDS) testing after initial evaluation by their physician

Exclusion Criteria:

  • pelvic organ prolapse beyond stage 1 Pelvic Organ Prolapse- Quantification (POP-Q) as diagnosed by the examining physician
  • any other clinical diagnosis other than urinary incontinence who undergo UDS testing ( e.g. interstitial cystitis, overactive bladder dry, bladder outlet obstruction)
  • were taking alpha agonists or anticholinergic medications within 2 weeks of the testing
  • had an elevated Post Void Residual (PVR) >50cc
  • any physical or mental disability that would either not allow participation or impede the ability to give fully informed consent
  • pregnancy

Responsible Party: Joseph Henderson, MD, University Hospitals Cleveland Medical Center
ClinicalTrials.gov Identifier: NCT02742584     History of Changes
Other Study ID Numbers: 07-11-37
First Posted: April 19, 2016    Key Record Dates
Last Update Posted: April 21, 2016
Last Verified: April 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Joseph Henderson, University Hospitals Cleveland Medical Center:
cough stress test
urodynamics
pad test

Additional relevant MeSH terms:
Urinary Incontinence
Enuresis
Urinary Incontinence, Stress
Urination Disorders
Urologic Diseases
Lower Urinary Tract Symptoms
Urological Manifestations
Signs and Symptoms
Behavioral Symptoms
Elimination Disorders
Mental Disorders