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Clinical Interest of the Temporary Urethral Stent Allium " Bulbar Urethral Stent " in the Treatment of Detrusor Sphincter Dyssynergia

Phase 1
Completed
Conditions
Detrusor Striated Sphincter Dyssynergia (DSSD)
Interventions
Device: Allium " Bulbar Urethral Stent " (BUS) system
Registration Number
NCT02323243
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

Detrusor striated sphincter dyssynergia (DSSD) is defined as the persistence or increasing of the striated sphincter activity during voiding and characterizes the spinal cord injuries located under the protuberance. The standard treatment for DSSD is medical, either pharmacological or by clean intermittent self-catheterisation (CISC). Some patients are unable to perform CISC and require alternative surgical techniques such as external sphincterotomy which is invasive, irreversible and with no adjustment period for the patient.

Urethral stents have been developed as an alternative to surgical sphincterotomy. Temporary stents provide a non-definitive treatment, especially for evolutionary pathologies, for patients refusing a destructive surgery (psychosocial impact), or for patients having not defined yet their therapeutic preference. The Allium company has developed the " Bulbar Urethral Stent " (BUS) system, which advantages are the possibility to perform the procedure under local anesthesia and to remove more easily the stent, with similar performances compared to the other devices. In order to quantify the interest of the BUS system, the investigators propose to perform a prospective study aimed at describing its technical and clinical results in terms of efficacy and safety.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
9
Inclusion Criteria
  • Male patient aged more than 18 years old
  • Presenting detrusor striated sphincter dyssynergia in the opinion of the investigator, based on clinical data and proven urodynamically
  • Detrusor striated sphincter dyssynergia with identified neurological origin
  • With contraindication or failure of the conventional treatments
  • Accepting the principle of the prosthetic incontinentation
  • Having given his signed consent to participate in the study
  • Affiliated with a social security scheme or assimilated.
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Exclusion Criteria
  • Minor patient or protected adult according to the terms of the law
  • Presenting contraindications to local regional anaesthesia
  • Presenting contraindications or a previous failure to the treatment by prosthetic sphincterotomy
  • Unable to hold a penile sheath.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Allium BUSAllium " Bulbar Urethral Stent " (BUS) systemTemporary urethral stent
Primary Outcome Measures
NameTimeMethod
Percentage of patients who perceive their voiding condition improved or very improvedOne month after the surgical intervention

The perception of voiding condition by the patient will be measured with a 5-point Likert Scale. The patient will have to define the voiding condition compared to the initial (pre-procedure), as: very worse, worse, non-changed, improved, or very improved

Secondary Outcome Measures
NameTimeMethod
Number of stent removals performed without hemorrhage12 months after the surgical intervention
Number of patients requesting a change in the voiding method, i.e. premature removal of the stentUp to 12 months following the surgical intervention
Number of complications, i.e. symptomatic urinary tract infections, encrustations, stenosis and hematuria, need for re-intervention and removals of the stentUp to 12 months after the surgical intervention
Number of stents correctly positionedImmediately after the surgical intervention
Maximum detrusor pressure and maximum urethral closure pressure, measured during the urodynamic testingAt inclusion, 1 month, 3 months, 6 months and 12 months after the surgical intervention
QUALIVEEN short form score (approved in French)At inclusion and 1 month, 3 months, 6 months and 12 months after the surgical intervention
Number of stent migrations1 month, 3 months, 6 months and 12 months after the surgical intervention
Post-void residual volume measured by retrograde urinary urethrocystographyAt inclusion and 1 month, 3 months, 6 months and 12 months after the surgical intervention

Trial Locations

Locations (1)

Service de Chirurgie-Urologie - Centre Hospitalier Lyon Sud

🇫🇷

Pierre Bénite cedex, France

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