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Urinary IncontinencePhase 2/3SISTErNCT00064662

Comparison of Surgical Procedures to Reduce Urinary Stress Incontinence

A Phase 2/3 study testing Burch Modified Tanagho and Autologous Fascia Sling in people with Urinary Incontinence, run by Carelon Research at 9 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary aim of this clinical trial is to compare the treatment success for two surgical procedures that are frequently used and have similar cure rates, yet have not been compared directly to each other in a large, rigorously conducted randomized trial. Read more about this study

Who is it for?
Ages 21 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Urinary Incontinence
What is being tested?
Burch Modified Tanagho and Autologous Fascia Sling
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
655 participants
Where
9 sitesUnited States
Study dates
Feb 2002to Mar 2010
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult
  • Predominant stress urinary incontinence by self-report,examination and test;
  • Urethral hypermobility;
  • Eligible for both surgical procedures;
  • Ambulatory;
  • Not pregnant;
  • >12 months post-partum;
  • No systemic disease known to affect bladder function;
  • No current chemotherapy or radiation therapy;
  • No urethral diverticulum, augmentation cytoplasty, or artificial sphincter;
  • No recent pelvic surgery;
  • Available for follow-up and able to complete study assessments;
  • Signed informed consent.

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

United States9 sites
  • University of Maryland

    Baltimore, Maryland, 21201

  • University of Alabama

    Birmingham, Alabama, 35249-7333

  • University of Texas, Southwestern

    Dallas, Texas, 75390-9110

  • Loyola University Medical Center

    Maywood, Illinois, 60153

  • University of Pittsburgh

    Pittsburgh, Pennsylvania, 15213

  • Beaumont Hospital

    Royal Oak, Michigan, 48073

  • University of Utah

    Salt Lake City, Utah, 84132

  • University of Texas Health Sciences Center

    San Antonio, Texas, 78229-3900

  • University of California

    San Diego, California, 92037

Other trials in United States

About this study

Official title: Randomized Clinical Trial of the Burch Modified Tanagho and Autologous Fascia Sling Procedures for Women With Predominantly Stress Urinary Incontinence

The primary aim of this clinical trial is to compare the treatment success for two surgical procedures that are frequently used and have similar cure rates, yet have not been compared directly to each other in a large, rigorously conducted randomized trial. The secondary aims of the trial are to compare other outcomes for the two surgical procedures, including quality of life, sexual function, satisfaction with treatment outcomes, complications, and need for other treatment(s)after surgery. Follow-up will be a minimum of two years and up to four years.

Being tested
Burch Modified Tanagho, Autologous Fascia Sling
Keywords
Stress urinary incontinence, Surgery
Medical subject headings
Urinary Incontinence, Urinary Incontinence, Stress

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Burch Modified TanaghoProcedure or surgery

    The Burch colposuspension is a well-established procedure for surgically treating women with stress urinary incontinence. The Burch modified colposuspension suspends the anterior vaginal wall (at the level of the bladder neck) with permanent sutures tied to the iliopectineal ligament.

  • Autologous Fascia SlingProcedure or surgery

    The fascial sling is also a well-established procedure for surgically treating women with stress urinary incontinence. The autologous sling procedure places a harvested strip of rectus fascia transvaginally at the level of the proximal urethra. The fascial strip is secured superiorly to the rectus fascia with permanent sutures

Study groups in NCT00064662
Study groupRoleWhat they receive
BurchOtherThe Burch colposuspension
Receives: Procedure: Burch Modified Tanagho
SlingOtherPubovaginal sling, using autologous rectus fascia
Receives: Procedure: Autologous Fascia Sling

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 24 Month Cumulative Success Rate Computed From Kaplan Meier Time-to-event Analysis (Reported as Percent Success).

    Success defined as composite measure including: no self-reported incontinence symptoms reported on the Medical, Epidemiologic, and Social Aspects of Aging Project (MESA) questionnaire, <15g in pad weight during 24 hr pad test, no incontinence episodes on 3-day voiding diary, negative results (no leakage) on provocative stress test at standardized bladder volume, no retreatment for urinary incontinence. Additional treatment for stress urinary incontinence (SUI) includes anti-incontinence surgery, tightening of sling, collagen injections, medication, behavioral treatment, or devices specifically for the treatment of SUI.

    Measured: Two years

  2. 24 Month Cumulative Stress Specific Success Rates Computed From Kaplan Meier Time-to-event Analysis (Reported as % Success)

    Stress-specific success defined by composite measure including: no self-reported symptoms of stress incontinence reported on the Medical, Epidemiologic, and Social Aspects of Aging Project (MESA) questionnaire , negative results (no leakage) on a provocative stress test at standardized bladder volume and no retreatment for stress incontinence Additional treatment for SUI includes anti-incontinence surgery, tightening of sling, collagen injections, medication, behavioral treatment, or devices specifically for the treatment of SUI.

    Measured: Two years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jul 2003 (estimated)
  2. Study startFeb 2002
  3. Primary completionJun 2006
  4. Study completionMar 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
655 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00064662
Sponsor's protocol ID
UITN-RCT (completed)
Acronym
SISTEr
Status last verified
May 2013
First submitted
10 Jul 2003
Last updated
10 May 2013
Data monitoring committee
No

Publications

  • Albo M, Wruck L, Baker J, Brubaker L, Chai T, Dandreo KJ, Diokno A, Goode P, Kraus S, Kusek JW, Lemack G, Lowder J, Steers W; Urinary Incontinence Treatment Network. The relationships among measures of incontinence severity in women undergoing surgery for stress urinary incontinence. J Urol. 2007 May;177(5):1810-4. doi: 10.1016/j.juro.2007.01.032.

    PubMed 17437826
  • Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, Chai TC, Zyczynski H, Diokno AC, Tennstedt S, Nager C, Lloyd LK, FitzGerald M, Lemack GE, Johnson HW, Leng W, Mallett V, Stoddard AM, Menefee S, Varner RE, Kenton K, Moalli P, Sirls L, Dandreo KJ, Kusek JW, Nyberg LM, Steers W; Urinary Incontinence Treatment Network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007 May 24;356(21):2143-55. doi: 10.1056/NEJMoa070416. Epub 2007 May 21.

    PubMed 17517855
  • Brubaker L, Chiang S, Zyczynski H, Norton P, Kalinoski DL, Stoddard A, Kusek JW, Steers W; Urinary Incontinence Treatment Network. The impact of stress incontinence surgery on female sexual function. Am J Obstet Gynecol. 2009 May;200(5):562.e1-7. doi: 10.1016/j.ajog.2008.11.017. Epub 2009 Mar 16.

    PubMed 19286143
  • Brubaker L, Stoddard A, Richter H, Zimmern P, Moalli P, Kraus SR, Norton P, Lukacz E, Sirls L, Johnson H; Urinary Incontinence Treatment Network. Mixed incontinence: comparing definitions in women having stress incontinence surgery. Neurourol Urodyn. 2009;28(4):268-73. doi: 10.1002/nau.20698.

    PubMed 19274758
  • Burgio KL, Brubaker L, Richter HE, Wai CY, Litman HJ, France DB, Menefee SA, Sirls LT, Kraus SR, Johnson HW, Tennstedt SL. Patient satisfaction with stress incontinence surgery. Neurourol Urodyn. 2010 Nov;29(8):1403-9. doi: 10.1002/nau.20877.

    PubMed 20976815
  • Chai TC, Albo ME, Richter HE, Norton PA, Dandreo KJ, Kenton K, Lowder JL, Stoddard AM; Urinary Incontinence Treatment Network. Complications in women undergoing Burch colposuspension versus autologous rectus fascial sling for stress urinary incontinence. J Urol. 2009 May;181(5):2192-7. doi: 10.1016/j.juro.2009.01.019. Epub 2009 Mar 17.

    PubMed 19296969
  • FitzGerald MP, Burgio KL, Borello-France DF, Menefee SA, Schaffer J, Kraus S, Mallett VT, Xu Y; Urinary Incontinence Treatment Network. Pelvic-floor strength in women with incontinence as assessed by the brink scale. Phys Ther. 2007 Oct;87(10):1316-24. doi: 10.2522/ptj.20060073. Epub 2007 Aug 7.

    PubMed 17684087
  • Kenton K, Richter H, Litman H, Lukacz E, Leng W, Lemack G, Chai T, Arisco A, Tennstedt S, Steers W; Urinary Incontinence Treatment Network. Risk factors associated with urge incontinence after continence surgery. J Urol. 2009 Dec;182(6):2805-9. doi: 10.1016/j.juro.2009.08.032. Epub 2009 Oct 17.

    PubMed 19837421
  • Kirby AC, Nager CW, Litman HJ, FitzGerald MP, Kraus S, Norton P, Sirls L, Rickey L, Wilson T, Dandreo KJ, Shepherd JP, Zimmern P; Urinary Incontinence Treatment Network. Preoperative voiding detrusor pressures do not predict stress incontinence surgery outcomes. Int Urogynecol J. 2011 Jun;22(6):657-63. doi: 10.1007/s00192-010-1336-5. Epub 2010 Dec 10.

    PubMed 21153471
  • Kraus SR, Markland A, Chai TC, Stoddard A, FitzGerald MP, Leng W, Mallett V, Tennstedt SL; Urinary Incontinence Treatment Network. Race and ethnicity do not contribute to differences in preoperative urinary incontinence severity or symptom bother in women who undergo stress incontinence surgery. Am J Obstet Gynecol. 2007 Jul;197(1):92.e1-6. doi: 10.1016/j.ajog.2007.03.072.

    PubMed 17618773
  • Lemack GE, Krauss S, Litman H, FitzGerald MP, Chai T, Nager C, Sirls L, Zyczynski H, Baker J, Lloyd K, Steers WD; Urinary Incontinence Treatment Network. Normal preoperative urodynamic testing does not predict voiding dysfunction after Burch colposuspension versus pubovaginal sling. J Urol. 2008 Nov;180(5):2076-80. doi: 10.1016/j.juro.2008.07.027. Epub 2008 Sep 18.

    PubMed 18804239
  • Lemack GE, Xu Y, Brubaker L, Nager C, Chai T, Moalli P, Kraus SR, Kerr L, Sirls L, Stoddard A; Urinary Incontinence Treatment Network. Clinical and demographic factors associated with valsalva leak point pressure among women undergoing burch bladder neck suspension or autologous rectus fascial sling procedures. Neurourol Urodyn. 2007;26(3):392-6. doi: 10.1002/nau.20325.

    PubMed 17304525
  • Mallett VT, Brubaker L, Stoddard AM, Borello-France D, Tennstedt S, Hall L, Hammontree L; Urinary Incontinence Treatment Network. The expectations of patients who undergo surgery for stress incontinence. Am J Obstet Gynecol. 2008 Mar;198(3):308.e1-6. doi: 10.1016/j.ajog.2007.09.003.

    PubMed 18313452
  • Markland AD, Kraus SR, Richter HE, Nager CW, Kenton K, Kerr L, Xu Y; Urinary Incontinence Treatment Network. Prevalence and risk factors of fecal incontinence in women undergoing stress incontinence surgery. Am J Obstet Gynecol. 2007 Dec;197(6):662.e1-7. doi: 10.1016/j.ajog.2007.08.062.

    PubMed 18060972
  • Nager CW, Albo ME, Fitzgerald MP, McDermott S, Wruck L, Kraus S, Howden N, Norton P, Sirls L, Varner E, Zimmern P; Urinary Incontinence Treatment Network. Reference urodynamic values for stress incontinent women. Neurourol Urodyn. 2007;26(3):333-40. doi: 10.1002/nau.20348.

    PubMed 17315221

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Burch Modified Tanagho and Autologous Fascia Sling in people with Urinary Incontinence, run by Carelon Research at 9 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Sep 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

24 Month Cumulative Success Rate Computed From Kaplan Meier Time-to-event Analysis (Reported as Percent Success). (time frame: Two years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00064662, which also lists 39 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2013.

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