Uterine Prolapse Without Vaginal Wall Prolapse
Conditions
Keywords
prolapse, sacrospinous fixation, minimally invasive
Brief summary
The objective of the study is to assess the long term safety, durability of clinical effectiveness and cost effectiveness of the NeuGuide™ system when used for vaginal colpopexy in the treatment of uterine prolapse.
Interventions
The NeuGuide™ device is indicated for anchoring sutures to ligaments of the pelvic floor.
Sponsors
Study design
Eligibility
Inclusion criteria
1. Patient with POP-Q C point greater than (-) 1 cm. 2. Patients who have previously had a partial hysterectomy in which the cervix is intact may be included in this study. 3. Non-pregnant female (female of child bearing potential must have a negative pregnancy test). 4. Patient understands the nature and potential hazards of the procedure and provides written informed consent prior to any study specific assessments. 5. Patient is able to complete written questionnaires. 6. Patient is willing and able to comply with the specified study requirements and follow-up assessments, and can be contacted by telephone.
Exclusion criteria
1. Known diagnosis of reproductive tract abnormalities. 2. Prior pelvic radiation therapy, any malignancy or active pelvic inflammatory disease. 3. Known history of severe Pelvic Inflammatory Disease (PID). 4. Prior total hysterectomy. 5. Prior pelvic prolapse surgery using synthetic mesh. 6. Pathological PAP in the past year. 7. Moderate or severe bacterial cervicitis. 8. Moderate or severe pelvic pain (\> 3 on VAS). 9. Severe morbid obesity (BMI \>45). 10. Temperature \> 38°C (oral or equivalent), sepsis, or active infection requiring IV anti-microbial treatment. 11. Significant cognitive impairment. 12. Active malignancy other than non-melanoma skin cancer. 13. Planned surgery (more than a minor one) in the next 30 days. 14. Patient has a known hypersensitivity to device materials (Nickel, suture material). 15. Moribund patient or patient with severe or deteriorating damage in critical body systems. 16. Any condition that in the judgment of the investigators would interfere with the subject's ability to provide informed consent, comply with study instructions, place the subject at increased risk, or which might confound interpretation of study results. 17. Concurrent enrollment in another device or drug trial that has not completed the primary endpoint or clinically interferes with the current study endpoints.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| A composite of the Pelvic Organ Prolapse Quantification (POP-Q) C point score, patient-rated symptom of vaginal bulging after vaginal colpopexy performed using the NeuGuide™ and the absence of further surgical therapy for uterine prolapse. | 12 months | Primary composite performance outcome |
| The number of device / procedure related Serious Adverse Events (SAE). | 30 days | Primary safety of surgical implantation as reflected by adverse events |
| The number of Serious Adverse Events and Adverse Events. | 12 months | Primary safety of NeuGuide treatment as reflected by adverse events |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The time utilization of staff performing the NeuGuide procedure. | one month | Secondary outcome: Cost performance of the procedure |
| Change in mean POP-Q C point score from baseline (cm). | one month | Secondary anatomical performance of the NeuGuide treatment |
| The POP-Q Stage Score calculated from POP-Q measurements, where the Stages of POP-Q system measurement are as follows: Stage 0 no prolapse is demonstrated Stage 1 the most distal portion of the prolapse is more than 1 cm above the level of the hymen | Baseline | Secondary outcome: POP-Q Stage Score. |
| Number of subjects who require surgical therapy of uterine prolapse or urinary incontinence. | 36 months | Secondary performance: durability of the NeuGuide treatment |
| Number of subjects in whom the primary symptomatic reason for repair of prolapse persists. | 12 months | Secondary symptomatic performance of the NeuGuide treatment |
Countries
Germany, Israel, United States