VIveve Treatment of the Vaginal Introitus to EValuate Effectiveness

Not Applicable

Completed

Conditions: Vaginal Laxity Following Childbirth
Sexual Function Following Childbirth

Interventions: Device: Active Treatment Viveve
Device: Sham Treatment Viveve

Registration Number: NCT02261974

Lead Sponsor: Viveve Inc.

Brief Summary: Outside United States (OUS) Post-Market Parallel Group Exploratory Study Design

The objective of this study is to determine the safety and effectiveness of the Viveve System to treat the vaginal introitus in women following vaginal birth(s) and in so doing improving vaginal laxity.

Detailed Description: A prospective, longitudinal, randomized, single-blind, sham controlled clinical study is planned. This study is designed to demonstrate that the active treatment (i.e., Viveve Procedure) is superior to the sham treatment for the primary effectiveness and safety endpoints.

Approximately 113 evaluable subjects will be randomized in a 2:1 ratio to either the active treatment group or sham group. The active treatment group will receive a treatment dose of 90 J/cm2 and the sham group will receive a sub-treatment dose of ≤1 J/cm2.

Subjects will be followed up at 72 hrs, 10 days, and one, two, three, and six months post treatment.

Final data will be reported at 6 months for active and sham treatments.

Recruitment & Eligibility

Status: COMPLETED

Sex: Female

Target Recruitment: 186

Inclusion Criteria

Able to understand and voluntarily sign the informed consent form
Pre-menopausal and ≥ 18 years of age
At least one full term vaginal delivery (> 37 completed weeks gestation) at least 12 months prior to enrollment date
Experiences vaginal looseness (laxity) during vaginal intercourse
Subject must have a screening blood count and metabolic panel including FSH level of <35 mIU/mL (35 IU/L).
Subject must have a normal pelvic exam at baseline and negative chlamydia and gonorrhea cultures during the screening period.
Subject had a normal PAP within last three years, cytology, no HPV and within last five years, cytology and no HPV.
Subject must be willing to engage in vaginal intercourse at least once per month.
Subject must be in a monogamous, heterosexual relationship for at least six months prior to screening visit with a partner who is sexually functional and available at least 50% of the time.
Subject is surgically sterilized, or is willing to use an acceptable method of birth control that was begun at least 3 month prior to screening and to be continued or throughout the duration of the study [i.e., barrier method (e.g., diaphragm), hormonal therapy (subcutaneous, injectable, or oral contraceptive) intrauterine device], or partner is surgically sterilized

Key

Exclusion Criteria

Pregnant or planning to become pregnant within the next 12 months or has had a delivery within the last 12 months.
Currently breastfeeding or discontinued breast feeding fewer than 6 months prior to enrollment
History of a genital fistula, a thin recto-vaginal septum as determined by the investigator, or history of a fourth degree laceration during screening physical exam
Clinically significant pelvic organ prolapse
Currently meets the criteria for a female sexual disorder, including DSM V, FSAD, FOD, Genitopelvic Pain, Sexual Aversion, Dyspareunia, or Vaginismus, and has not been treated for this condition within the past 12 months
Beck Depression Inventory score > 14
DSM-5 psychiatric diagnosis exhibiting clinically significant symptoms
Taking SSNRI or SSRI drugs
Not willing to abstain from vaginal intercourse or use of tampons until 10-day follow-up visit completed
Evidence of active sexually transmitted disease upon vaginal exam that precludes treatment
History of genital herpes
Clinically significant abnormalities in clinical chemistry or hematology at the time of screening
Currently taking prescribed medications, OTC products or supplements that may impact or enhance sexual function (e.g., antihypertensive, psychotropic, chemotherapeutic agent, PD5 Inhibitors) as assessed by the investigator
Currently undergoing chemotherapy, radiation therapy, or pelvic floor physical therapy
Has an implantable pacemaker, an automatic implantable cardioverter/defibrillator (AICD), or any other implantable electrical device, as these devices may be adversely affected by radiofrequency fields or current
Has undergone the Viveve Procedure previously
Has medical condition that in investigator's opinion may interfere with wound healing response
Has an acute or a chronic vaginal or vulvar disorder (e.g., vaginal atrophy, pain including vulvodynia, vulvar vestibulitis dysethetic vulvodynia or vulvar dystrophy, current/chronic papulosquamous vulvar dermatoses (e.g., psoriasis lichen planus, tinea cruris, lichen sclerosis, seborrhea dermatitis, contact or irritant dermatitis, lichen simplex, eczema) or bullous dermatoses or systemic diseases with potential involvement of vulva)
Has Irritable Bowel Syndrome or Crohn's Disease
Has dyspareunia defined as recurrent or persistent painful intercourse that affects sexual activity
Has been in another clinical study within four weeks of screening, or is not willing to abstain from enrolling in other clinical studies for duration of trial

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Active Viveve Treatment	Active Treatment Viveve	Intervention in the active arm will be with the Viveve System using 90 Joules/cm2 active treatment with radiofrequency energy in the vaginal introitus
Sham Viveve Treatment	Sham Treatment Viveve	Intervention in the sham arm will be with the Viveve System using ≤1 Joule/cm2 sham treatment with radiofrequency energy in the vaginal introitus

Primary Outcome Measures

Name	Time	Method
Mean Change From Baseline in Female Sexual Function Index (FSFI) Total Score	6 months	The mean change from baseline in FSFI total score in the active arm compared to the sham arm. The FSFI is a 19-item validated measure of female sexual function. It consists of 6 domains: Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain. Each item's score can range from 0-5 (or 1-5 in several instances). For individual domain scores, the scores of the individual items that comprise the domain are summed, and the sum is multiplied by the domain factor (factors are permanent and do not change). The 6 domain scores are then summed to obtain the FSFI total score. The total score ranges from 2-36. A higher score indicates a greater level of sexual function, while a lower score correlates to a greater level of sexual dysfunction. Within individual domains, a domain score of 0 indicates that the subject reported having no sexual activity during the past month. The baseline score is the FSFI total score from the screening visit.
Reporting Adverse Events (AEs)	6 months	Proportion of subjects in the active arm relative to those in the sham arm experiencing a treatment-related AE by six months post-intervention.

Secondary Outcome Measures

Name	Time	Method
Mean Change From Baseline in Vaginal Introitus Laxity Inventory (VALI) Total Score	6 months	Vaginal Introitus Laxity Inventory (VALI) is a 12-item patient reported outcome measure designed to describe and quantify the nature of a female respondent's concern with the perception of laxity ("looseness") and its impact on the qualities of satisfaction and enjoyment of her sexual functioning. Items of the VALI address the impact of laxity on the major aspects of the female sexual response cycle (i.e., sexual desire, arousal and orgasm), and quantify the patient's experience of sexual pleasure, sensitivity and satisfaction. The VALI items also address the potential impact of vaginal introitus laxity on sexual confidence and the patient's partner. All 12 items are measured on 5-point Likert scales (0= Very Poor, 1=Poor, 2=Moderate, 3=Good, 4=Very Good) and scores are summed to achieve a VALI Total score, range 0-48. A higher score corresponds to positive sexual satisfactions and functioning.
Mean Change From Baseline in the VSQ Vaginal Laxity Question (VLQ)	6 months	Mean change in VSQ Vaginal Laxity Question (VLQ) score from baseline to 6 months post-intervention. The VLQ is one question. The global assessment of vaginal laxity is scored on a seven-point Likert type scale where the response to the question ranges from 1-7 where 1 = "Very Loose" and 7 = "Very Tight". The Likert-scale is one of the most widely used bipolar scaling method instruments in survey research. The VSQ VLQs levels of vaginal laxity uses a balanced keying (an equal number of positive and negative statements) to obviate the problem of acquisition bias. Baseline VLQ is the score indicated that the screening visit.
Mean Change From Baseline in Female Sexual Distress Scale - Revised (FSDS-R)	6 months	The mean change in total FSDS-R score from baseline to six months post-intervention in the active arm compared to the sham arm. The FSDS-R is a 12-item patient-reported questionnaire and a validated scale used to measure sexually-related personal distress in women. Women rate 13 questions as Never (0), Rarely (1), Occasionally (2), Frequently (3), and Always (4), for a total score range of 0-52 (the individual question scores are summed to give the total score). A higher frequency of occurrences (which correlates to a total higher score) indicates a greater distress or a "worse outcome". The numbers below represent the changes from baseline in mean FSDS-R total score. The baseline value is the FSDS-R total score at screening.

Trial Locations

Locations (9): Allan Centre
🇨🇦
Calgary, Alberta, Canada
Exogenia Institute of Anti-Aging and Regenerative Medicine
🇨🇦
Sherbrooke, Canada
Complexe Medical St-Laurent
🇨🇦
Montreal, Quebec, Canada
Instituto Palacios, Salud de la Mujer
🇪🇸
Madrid, Spain
Unidad de Gestión Clínica de Obstetricia y Ginecología. Hospital Universitario Araba
🇪🇸
Vitoria, Spain
Research Center of Reproductive Medicine. - IRCCS Policlinico San Matteo Hospital
🇮🇹
Pavia, Italy
Yokohama Motomachi Jyosei Iryou Clinic Luna
🇯🇵
Kanagawa, Japan
Les Cours Medical Centre
🇨🇦
Montreal, Quebec, Canada
Naoe Beauty Clinic
🇯🇵
Tokyo, Japan