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Evaluation of High Intensity Focused Ultrasound (HIFU) in the Treatment of Rectal Endometriosis

Not Applicable
Completed
Conditions
Endometriosis, Rectum
Interventions
Device: HIFU treatment
Registration Number
NCT04494568
Lead Sponsor
EDAP TMS S.A.
Brief Summary

Rectal endometriosis (RE) induces lesions associated with painful symptoms that can alter quality of life. High Intensity Focused Ultrasound (HIFU) is a non-invasive ablative procedure using a high-intensity ultrasound probe to induce tissue devitalization using acoustic cavitation and thermal ablation. Focal One® is a transrectal HIFU device, which is validated to treat prostatic cancer.

The primary objective of this clinical investigation is to evaluate the safety of the HIFU treatment of rectal endometriosis with Focal One® HIFU device.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
60
Inclusion Criteria
  • Patients aged at least 25 years-old
  • Rectal endometriosis in preoperative imaging, without other digestive locations (colon, ileum and small intentine)
  • Symptomatic patient refusing hormonal treatment and/or surgery.
  • Endometriosic nodule visible on echography with contrast and confirmed in Gadolinium MRI and difusion sequence (according to standardized protocol)
  • Nodule with intrarectal protrusion of less than 50% (allowing the positioning of the probe in front of the rectal nodule)
  • Distance from the upper pole to the anal margin ≤ 15 cm (measurement by MRI with intra-rectal contrast)
  • No curent pregnancy (negative BHCG <72h before the HIFU procedure) and no pregnancy project within 6 months after the HIFU procedure (post-treatment MRI delay)
  • Patient agreeing not to change her hormone treatment for the duration of the study.
  • Patient accepting the study constraints
  • Health insurance affiliated patient or beneficiary of an equivalent coverage
Exclusion Criteria
  • Virgin patient
  • Ongoing uro-genital infection
  • Anorectal anatomy incompatible with HIFU therapy
  • History of segmental rectal resection with mechanical anastomosis, shaving or discoid resection
  • Patient with an implant within 1cm of the treatment area (stent, catheter, ESSURE® contraceptive implants).
  • Inflammatory colon disease (ulcerative colitis, Crohn's disease and others)
  • Latex allergy
  • Patient with contraindications to MRI
  • Patient with contraindications to Gadolinium injection
  • Patient previously treated with HIFU for a rectal endometriotic lesion
  • Patient not speaking nor reading French
  • Patient deprived of liberty following a legal or administrative decision
  • Patient under guardianship or tutelage measure

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
HIFU interventionHIFU treatmentpatients will benefit of an HIFU Treatment of their rectal endometriosis
Primary Outcome Measures
NameTimeMethod
Evaluate the tolerance of rectal endometriosis treatment with HIFU6 months

The tolerance of the treatment will be evaluated by the analysis of adverse events occurrence at 6 months post-HIFU treatment

Secondary Outcome Measures
NameTimeMethod
Evaluation of the of quality of life evolution of patients after HIFU treatmentat 1 month, 3 months and 6 months post-intervention,

Quality of life questionnaire : MOS- SF-36

Evaluation of the evolution of the nodule's volumeat 6 months

The pre- and post-treatment comparison of the volume of the endometriodsis nodule measurement.

Evaluation of the post-intervention analgesic treatmentduring the fisrt 10 days post treatment.

The level of medication during the fisrt 10 days post treatment will be studied by analysing the data collected in patient book.

Evaluation of the sexual symptoms evolution of patients after HIFU treatmentat 1 month, 3 months and 6 months post-intervention

SFSI questionnaire

Evaluation of the gynecological symptoms evolution of patients after HIFU treatmentat 1 month, 3 months and 6 months post-intervention

EVA symptom Questionnaires

Evaluation of the digestive symptoms evolution of patients after HIFU treatmentat 1 month, 3 months and 6 months post-intervention

Kess questionnaires

Evaluation of the urinary symptoms evolution of patients after HIFU treatmentat 1 month, 3 months and 6 months post-intervention

USP questionnaire

Trial Locations

Locations (5)

Clinique Tivoli-Ducos

🇫🇷

Bordeaux, France

CHU de Angers

🇫🇷

Angers, France

Hôpital BICETRE

🇫🇷

Le Kremlin-Bicêtre, France

Clinique de Gynécologie

🇫🇷

Lille, France

Hopital de la Croix Rousse

🇫🇷

Lyon, France

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