The Zenflow Spring System EU Safety and Performance Study

Not Applicable

• Conditions: Benign Prostatic Hyperplasia

• Registration Number: NCT03577236
• Lead Sponsor: Zenflow, Inc.

Brief Summary

The objectives of the trial are to demonstrate the safety and performance of the Zenflow Spring System in relieving the symptoms of obstructive Benign Prostatic Hyperplasia (BPH).

Detailed Description

A multi-center, prospective, single arm safety and performance trial. Subjects will be treated either in the Investigator's out-patient treatment room or in the OR, with local anaesthesia only. All subjects will be followed for the entire duration of the study until exit after the 60 month follow-up visit.

Study Timeline

• Study First Submitted: 2018-05-16
• Study First Submitted QC: 2018-07-02
• Study First Posted: 2018-07-05
• Study Start: 2019-01-16
• Status Verified: 2021-07
• Last Update Submitted: 2021-07-15
• Last Update Posted: 2021-07-22
• Primary Completion: 2022-12
• Study Completion: 2024-05-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Male
• Target Recruitment: 50

Inclusion Criteria

1. Patient is able and willing to comply with all the assessments of the study

2. Patient or patient's legal representative has been informed of the nature of the study, agrees to participate and has signed the informed consent form

3. ≥ 45 years of age

4. Baseline IPSS score > 13, and a baseline Quality of Life (QoL) question score > 3

5. Prostate volume 25 - 80 cc by Trans Rectal Ultrasound (TRUS) or abdominal ultrasound, measured within past 90 days and prostatic urethral length between 2.5- 4.5 cm

6. Failed, intolerant, or patient choice to not take a medication regimen for the treatment of LUTS

7. Patient must meet ONE of the following criteria:

   1. Baseline PSA <= 2.5ng/mL
   2. Baseline PSA >2.5 ng/mL and <=10 ng/mL AND free PSA >=25% of total PSA (no biopsy required or negative biopsy)
   3. Baseline PSA >10ng/mL AND negative prostate biopsy1 result within 12 months
   4. Negative prostate biopsy1 within 12 months if abnormal digital rectal examination
   5. 3 Tesla MRI of the prostate, with normal findings, within 12 months prior to the baseline visit

Exclusion Criteria

1. Obstructive intravesical median prostatic lobe which, in the opinion of the Investigator, would not benefit from treatment

2. Urethral stricture, meatal stenosis, or bladder neck obstruction - either current, or recurrent requiring 2 or more dilations as reported in the patient's history

3. Requiring self-catheterization to void

4. Baseline PSA > 10 ng/mL or confirmed or suspected prostate cancer

5. Any of the following, taken from a single uroflowmetry reading:

   1. Peak urinary flow rate > 12 ml/second
   2. Post-void residual (PVR) > 250 ml
   3. Peak Urinary flow rate of > 15 ml/second
   4. < 125ml urinary volume voided at baseline (pre-bladder urinary volume of ≥ 150 ml required)

6. Other condition or disease that might cause urinary retention

7. History of other diseases causing voiding dysfunction

8. Concomitant Urinary Tract Infection (UTI) (subject can be enrolled following successful treatment of UTI and a clean urine test), or a history of recurrent or chronic UTIs (defined as 2 or more UTIs in the past 12 months)

9. Concomitant bladder stones

10. Previous pelvic irradiation or radical pelvic surgery

11. Previous prostate surgery, stent implantations, laser prostatectomy, hyperthermia or another invasive treatment to the prostate

12. Chronic prostatitis, or recurring prostatitis within the past 12 months

13. Known allergy to nickel

14. Life expectancy less than 24 months

15. Use of concomitant medications (e.g., anticholinergics, antispasmodics or antidepressants) affecting bladder function

16. Inability to stop taking anticoagulants and/or antiplatelets for at least 3 days prior to the procedure or coumadin for at least 5 days prior to the procedure (low dose aspirin therapy not prohibited)

17. Taking 5-alpha reductase inhibitors within 3 months of pre-treatment (baseline) evaluation unless evidence of same drug dose for at least 6 months with a stable voiding pattern (the drug dose should not be altered or discontinued throughout the study)

18. Taking one of the following within 2 weeks of pre-treatment (baseline) evaluation:

    1. alpha-blockers,
    2. androgens,
    3. anticholinergics, or
    4. cholinergic medication gonadotropin releasing hormonal analogs

19. Taking one of the following within 24 hours of pre-treatment (baseline) evaluation:

    1. phenylephrine, or
    2. pseudoephedrine

20. Future fertility concerns

21. Any severe illness that might prevent study completion or would confound study results

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Need for urinary catheterization	7 days after the procedure	Rate of extended post-operative urinary catheterization
Successful placement of the Zenflow Spring Implant	Day of discharge up to 7 days following device placement	Successful deployment and procedural success for the Zenflow System to implant the Spring device in the operating room or an out-patient clinical setting.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH) using the International Prostate Symptom Score and Quality of Life Score (IPSS+QoL)	Baseline and 3 months	The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score. In addition the patient is asked 1 question related to his Quality of Life. The possible responses range from 0 to 6 where 0 is the best and 6 is the worst.

Secondary Outcome Measures

Name	Time	Method
Incidence of procedure or device related serious adverse events	Up to 30 days	Assessment of any device or procedure related Serious Adverse Events (SAE)
Assessment of Sexual Health Assessment: Change in sexual health measured by change in the Sexual Health Inventory for Men (SHIM) questionnaire score	Baseline, 3, 6, 12, & 24 months	The patient selects the most appropriate response to 5 questions about his sexual health. Each response has an assigned value between 1 and 5. The numeric values are tallied for a total score.
Assessment of Sexual Health Assessment: Change in sexual health measured by change in ability to ejaculate using the Male Sexual Health Questionnaire - Ejaculatory domain (MSHQ-EjD)	Baseline, 3, 6, 12, & 24 months	The patient selects the most appropriate response to 4 questions about his sexual health specific to ejaculation. Each response has an assigned value between 0 and 5.
Assessment of Pain, evaluated using a Visual Analog Score (VAS) of 1 to 10	Baseline, 2 weeks, 1 month and 3 months	Patient describes pain on a Visual Analog Scale (VAS). The scale is a line labeled 1 at the far left indicating minimal pain and 10 on the right, which is maximum pain.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)	Up to 2 years	Incidence of repeat invasive treatment for Lower Urinary Tract Symptoms (LUTS) or increase in dosage or initiation of new medication to treat symptoms of BPH.
Assessment of Adverse Events	Up to 2 years	Rate of adverse events related to the procedure or device.

Trial Locations

Locations (5)

Australian Clinical Trials; 🇦🇺 Wahroonga, New South Wales, Australia

South Coast Urology; 🇦🇺 Wollongong, New South Wales, Australia

Goldfields Urology; 🇦🇺 Bendigo, Victoria, Australia

Royal Melbourne Hospital; 🇦🇺 Melbourne, Victoria, Australia

Urology Bay of Plenty; 🇳🇿 Tauranga, New Zealand