Lower Urinary Tract Symptoms, Prostatic Cancer, Prostatic Hyperplasia, Urinary Retention
Conditions
Keywords
Temporary prostatic stent, Indwelling catheter, Cryotherapy, Prostate cancer, Benign prostatic hyperplasia, Rezum, EchoLaser
Brief summary
The goal of this single-centre prospective randomized clinical trial is to compare the post-operative use of temporary prostatic stent (Group 1) vs indwelling catheter (Group 2) in patients undergoing cryotherapy for targeted therapy of localized prostate cancer, transurethral water vapor energy ablation (REZUM) or transperineal laser ablation of the prostate with EchoLaser™ system for the treatment of benign prostatic hyperplasia (BPH) The main questions are: * Difference in quality of life, Lower Urinary Tract Symptoms (scored with IPSS, International Prostate Symptom Score), urinary continence symptoms (scored with International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, ICIQ-UI-SF) and patient satisfaction between indwelling catheter and temporary prostatic stent (Exime®) score with a non-validated questionnaire (Stent/catheter-related urinary symptoms questionnaire) * Difference in side effects and complications between indwelling catheter and temporary prostatic stent (Exime®) A total 120 of patients will be enrolled (Group 1: 60; Group 2: 60) with a 1:1 randomization ratio. The follow-up duration will be 6 months.
Interventions
DEVICETemporary prostatic stent (Exime®)
Placement of temporary prostatic stent (Exime®) following the procedure described in the product information
DEVICEIndwelling catheter
Placement of indwelling catheter
Sponsors
Lyx Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Prospective randomized clinical trial divided in 3 cohorts: HERMES\_CRYO (cryotherapy for targeted therapy of localized prostate cancer), HERMES\_REZUM \[water vapor energy ablation for the treatment of benign prostatic hyperplasia (BPH)\], and HERMES\_LASER \[ELESTA ECHOLASER® for the treatment of benign prostatic hyperplasia (BPH)\]. In each cohort, two arms will be compared: temporary prostatic stent vs indwelling catheter with a 1:1 randomization ratio.
Eligibility
Sex/Gender
MALE
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Willing and able to provide written informed consent prior to enrollment (if applicable). * Subjects must meet all inclusion criteria to be eligible for study enrollment. * Men between 18 and 85 years old. * Undergo focal therapy for prostate cancer, water vapour energy ablation Rezum® or EchoLaser®. * Willing to be seen by the investigator and answer questions and fill out questionnaires up to a month after surgery.
Exclusion criteria
* Urethral stricture \<22F. * Gross haematuria * Prostate volume \> 80cc * Prostate craniocaudal length \> 6cm * Patients with long-term urinary catheters or other urinary drainage systems * Lack of commitment on the part of the patient to attend the follow-up as required.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Device-related quality of life | 1 week | Evaluation of impact on patient quality of life associated with the urinary device will be based on the sixth question (Q6) of a non validated questionnaire (Stent/catheter-related urinary symptoms questionnaire), defined as: Q6: How much has the bladder catheter/Exime affected your quality of life? Quantitative answer, ranging from 0 to 10. Being zero, not affected; and being ten, very affected |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Device-related patient satisfaction | 1 week | Evaluation of satisfaction of patients associated with the device will be based on the seventh question (Q7) of a non validated questionnaire (Stent/catheter-related urinary symptoms questionnaire), defined as: Q7. What is your degree of satisfaction while wearing the catheter/Exime®? Quantitative answer, ranging from 0 to 10. Being zero, not satisfied at all; and being ten, completely satisfied |
| Device-related Lower Urinary Tract Symptoms (LUTS) | From device-placement to 6 months after treatment | Evaluation of impact of the device on LUTS will be based on a validated questionnaire administered before the device-placement, at device-removal, at 4 weeks and finally at 6 months after treatment: \- International Prostate Symptom Score (IPSS), min 0 - max 35 points, in which higher values are associated with worsening urinary symptoms |
| Occurence of perioperative events (< or = 24h after treatment) | 1 post-operative day | Evaluation of perioperative events (\< or = 24h after treatment) defined as complications (classified according to the Clavien - Dindo scale), presence of haematuria, pain (based on visual analogue pain score), occurence of acute urinary retention or need to perform urinary catheter bladder washout. |
| Device-related urinary side effects | 1 week | Evaluation will be based on the first five questions (Q1 - Q5) of a non validated questionnaire with quantitative answers ranging from 0 to 10, defined as: Q1:How much urine leakage have you had while carrying the bladder catheter or the Exime® device? (0: none -\> 10 a lot of leakage = need to use several diapers) Q2. How much pain, discomfort or spasms have you had in relation to the catheter/Exime®? (0: none -\> 10: a lot of pain = need for prescribed analgesia) Q3. How much bleeding have you had with urine while wearing the catheter/Exime®? (0: none -\> 10: a lot of bleeding = need for change of clothing) Q4. How much has the urine been different? (darker than usual, worse odor, or sediment)? (0: nothing -\> 10: very strong odor, very dark urine, presence of lumps) Q5. Have you had any problems in handling the catheter? (0: no problems at all -\> 10: many problems) |
| Overall satisfaction outcomes | 4 week | Evaluation of overall satisfaction will be based on the question How satisfied are you overall with the treatment you have received? (Quantitative answer, ranging from 0 to 10. Being zero, not satisfied at all; and being ten, completely satisfied) administered at 4 week post-treatment. |
| Urine flow rate | From device-placement to 6 months after treatment | Maximal flow rate \[Q max (ml/s)\] will be evaluated performing a uroflowmetry at baseline, at week 4, and finally at 6 months after treatment. |
| Device-related continence symptoms | From device-placement to 6 months after treatment | Evaluation of impact of the device on continence symptoms will be based on a validated questionnaire administered before the device-placement, at device-removal, at 4 weeks and finally at 6 months after treatment: \- International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF): min 0 - max 21 points, the higher the score, the more severe is the urinary incontinence, but there is no normal score. |
| Occurrence of postoperative events (>24h-1week) | 1 week | Evaluation of postoperative events (\>24h-1week) defined as acute urinary retention or need to perform urinary catheter bladder washout, need to change urinary catheter or presence of urinary tract infection (presence of fever or need to change antibiotic therapy) and others complications (classified according to the Clavien - Dindo scale) |
Countries
Spain
Contacts
Primary ContactJuan I Martinez-Salamanca, MD PhD FEBU FACS FEBSM
Outcome results
None listed