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A Real World Study of eCoin for Urgency Urinary Incontinence: Post Approval Evaluation (RECIPE)

Not Applicable
Recruiting
Conditions
Urinary Urge Incontinence
Overactive Bladder
Urge Incontinence
Incontinence, Urinary
Interventions
Device: eCoin Tibial Nerve Stimulation
Registration Number
NCT05685433
Lead Sponsor
Valencia Technologies Corporation
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.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
eCoin Tibial Nerve StimulationeCoin Tibial Nerve StimulationSubcutaneous stimulation of the tibial nerve using the eCoin device.
Primary Outcome Measures
NameTimeMethod
Responder Rate12 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 Outcome Measures
NameTimeMethod
Responder Rate24 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 Data24 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.

Trial Locations

Locations (40)

UPNT Research Institute

🇺🇸

Arlington, Texas, United States

The Emory Clinic

🇺🇸

Atlanta, Georgia, United States

The Methodist Hospital Research Institute

🇺🇸

Houston, Texas, United States

Cypress Medical Research

🇺🇸

Wichita, Kansas, United States

Rush University

🇺🇸

Chicago, Illinois, United States

Weill Cornell Medicine: Department of Urology

🇺🇸

New York, New York, United States

USA Health

🇺🇸

Mobile, Alabama, United States

Specialty Clinical Research of St. Louis

🇺🇸

Saint Louis, Missouri, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

University of Kansas Medical Center Research Institute, Inc

🇺🇸

Kansas City, Kansas, United States

Minnesota Urology

🇺🇸

Woodbury, Minnesota, United States

Southern Urogynecology

🇺🇸

West Columbia, South Carolina, United States

Louisiana State University Health Sciences Center

🇺🇸

Shreveport, Louisiana, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

The Oregon Clinic

🇺🇸

Portland, Oregon, United States

Urology Centers of Alabama

🇺🇸

Homewood, Alabama, United States

Arkansas Urology

🇺🇸

Little Rock, Arkansas, United States

University of California, Irvine

🇺🇸

Irvine, California, United States

AIR Research

🇺🇸

Los Angeles, California, United States

Stanford Health

🇺🇸

Stanford, California, United States

Urology Centers of Alabama

🇺🇸

Homewood, Alabama, United States

USA Health

🇺🇸

Mobile, Alabama, United States

Arkansas Urology

🇺🇸

Little Rock, Arkansas, United States

University of California, Irvine

🇺🇸

Irvine, California, United States

AIR Research

🇺🇸

Los Angeles, California, United States

Stanford Health

🇺🇸

Stanford, California, United States

The Emory Clinic

🇺🇸

Atlanta, Georgia, United States

Rush University

🇺🇸

Chicago, Illinois, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

University of Kansas Medical Center Research Institute, Inc

🇺🇸

Kansas City, Kansas, United States

Cypress Medical Research

🇺🇸

Wichita, Kansas, United States

Louisiana State University Health Sciences Center

🇺🇸

Shreveport, Louisiana, United States

Minnesota Urology

🇺🇸

Woodbury, Minnesota, United States

Specialty Clinical Research of St. Louis

🇺🇸

Saint Louis, Missouri, United States

Weill Cornell Medicine: Department of Urology

🇺🇸

New York, New York, United States

The Oregon Clinic

🇺🇸

Portland, Oregon, United States

Southern Urogynecology

🇺🇸

West Columbia, South Carolina, United States

UPNT Research Institute

🇺🇸

Arlington, Texas, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

The Methodist Hospital Research Institute

🇺🇸

Houston, Texas, United States

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