Incontinence, Urinary, Overactive Bladder, Urge Incontinence, Urinary Urge Incontinence
Conditions
Brief summary
A prospective, multicenter, single-arm study to evaluate the safety and effectiveness of the eCoin® implanted tibial nerve stimulator in subjects with urgency urinary incontinence (UUI).
Detailed description
The goal of this prospective, multicenter, single-arm study is to assess the long-term safety and effectiveness of the FDA approved eCoin® implanted tibial nerve stimulator in a real world setting. Eligible subjects having overactive bladder (OAB) with urgency urinary incontinence (UUI) will be implanted with the eCoin® implanted tibial stimulator and complete voiding diaries and questionnaires at follow-up visits through 5 years.
Interventions
Subcutaneous stimulation of the tibial nerve using the eCoin device.
Sponsors
Valencia Technologies Corporation
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Women and men above 18 years old with gender percentages reflective of disease prevalence in the U.S. population * Individual with diagnosis of overactive bladder with urgency urinary incontinence. * Individual has at least one urgency urinary incontinence episode on each of three days as determined on a 3-day voiding diary. * Individual gives written informed consent. * Individual is mentally competent and able to understand all study requirements. * Individual is willing and able to complete a 3-day voiding diary and quality of life questionnaire. * Individual is without pharmacological treatment of overactive bladder (anticholinergic and β3-adrenoceptor agonists) for 2 weeks prior to baseline or longer if the physician judges that the therapeutic effect is still present. * Individual is intolerant of or has an inadequate response to any of anticholinergics, β3-adrenoceptor agonists, onabotulinumtoxinA, or who have undergone percutaneous tibial nerve stimulation (PTNS). * Individual is determined to be a suitable surgical candidate by physician. * Individual is appropriate for eCoin treatment based on the US FDA-approved IFU requirements.
Exclusion criteria
* Individual is not appropriate for eCoin therapy based upon the US FDA-approved IFU requirements. * Individual has clinically significant bladder outlet obstruction. (Suspected bladder outlet obstruction will be initially assessed by uroflow study with those having a maximum flow rate \< 15mL/s requiring additional evaluation.) * Individual has predominantly stress urinary incontinence (greater than 1/3 of leaks on baseline diary are stress). * Individual has an active urinary tract infection at time of enrollment. * Individual has known polyuria. * Individual has significant lower urinary tract pain or has been diagnosed with interstitial cystitis or bladder pain syndrome. * Individual has abnormal post void residual (i.e. greater than 200 cc initially and on repeat testing after double voiding) * Individual has clinically significant urethral stricture disease or bladder neck contracture. (Suspected disease or contracture will be initially assessed by uroflow study with those having a maximum flow rate \< 15mL/s requiring additional evaluation.) * Individual has chronic venous insufficiency with a history of skin change (hyperpigmentation, lipodermatosclerosis, ulceration) in the ankle region. * Individual has morbid obesity and in the opinion of the investigator is not a good candidate for the study. * Individual has had diagnosis of bladder, urethral, or prostate cancer. * Individual has had a prior anti-stress incontinence sling surgery within the last year. * Individual is pregnant or intends to become pregnant during the study. * Individual has the presence of urinary fistula, bladder stone, or interstitial cystitis. * Individual has uncontrolled diabetes mellitus (Hemoglobin A1C\>7) or diabetes with significant peripheral complications. (Uncontrolled diabetes will be ruled out by blood test excluding those with Hemoglobin A1C\>7). * Individual has an implantable neurostimulator, pacemaker, or implantable cardiac defibrillator (ICD). * Individual has been treated with onabotulinumtoxinA in the previous 9 months prior to enrollment, or more time if the principal investigator judges that the therapeutic effect is present. * Individual has been treated with percutaneous tibial nerve stimulation (PTNS) within the previous 4 weeks prior to enrollment or more time if the principal investigator judges that the therapeutic effect is present. * Individual is currently using transcutaneous electrical nerve stimulation (TENS) in the pelvic region, back, or legs. * Individual is aware that he or she will need an MRI scan other than a head/neck/shoulder MRI during the study period. * Individual has a clotting or bleeding disorder or is using anticoagulant therapies and in the opinion of the investigator is not a good candidate for the study (antiplatelet and anticoagulant therapy may be continued or held at the discretion of the investigator). * Individual is neutropenic or immune-compromised. * Individual has had previous surgery and/or significant scarring at the implant location. * Individual has ongoing dermatologic condition at the implant site, including but not limited to dermatitis and autoimmune disorders. * Individual has a clinically significant peripheral neuropathy in the lower extremities. * Individual has neurogenic bladder dysfunction. * Individual has pitting edema at implant location (≥ 2+ is excluded). * Individual has inadequate skin integrity or any evidence of an infection or inflammation in either lower leg. * Individual has varicose veins and is symptomatic. * Individual has open wounds, trauma, or prior surgery in the lower extremities. * Individual has arterial disease in the lower extremities. * Individual has vasculitis in the lower extremities. * Individual has bladder stones or neoplasia. (Suspected bladder stones or neoplasia will be ruled out with a urine dipstick showing no more than trace blood, and microscopic analysis (which should be done in that case) shows ≥3 PBC's /HPF unless that subject has been worked up and found negative for clinically significant disease such as malignant neoplasm or stones.) * In the opinion of the investigator, Individual is not a good candidate for participation in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Responder Rate | 12 months | Proportion of subjects achieving at least a 50% improvement in the number of urgency urinary incontinence episodes on a 3-day voiding diary. |
| Safety: 12 months rate of all device or procedure related AEs. | 12 months | Rate of all device or procedure related AEs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Responder Rate | 24 months | Proportion of subjects achieving at least a 50% improvement in the number of urgency urinary incontinence episodes on a 3-day voiding diary. |
| Safety Data | 24 months | Rate of all device or procedure related AEs through 24 months post activation of eCoin. |
| Safety data through 7 months post-reimplantation. | 7 months post reimplantation | Rate of device or procedure-related AEs through 7 months post reimplantation. |
Countries
United States
Contacts
CONTACTDylan Beyer
Outcome results
None listed