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Urethral StrictureVeSpARNCT03572348

VeSpAR: Comparing Vessel-Sparing Anastomotic Repair and Transecting Anastomotic Repair in Isolated Short Bulbar Strictures.

A study testing Transecting anastomotic repair (tAR) and Vessel-sparing anastomotic repair (vsAR) in people with Urethral Stricture and Surgery, run by University Hospital, Ghent at 13 sites in 8 countries.

Completed

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

Official record
Search all trials

Trial summary

The investigators want to verify whether the surgical outcome of vessel-sparing anastomotic repair in isolated short bulbar urethral strictures is not inferior to the surgical outcome of transecting anastomotic repair. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Urethral Stricture, Surgery, Urologic Diseases
What is being tested?
Transecting anastomotic repair (tAR) and Vessel-sparing anastomotic repair (vsAR)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
13 sitesin 8 countries
Study dates
26 Sep 2018to 14 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

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 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Voluntary signed written informed consent (according to the rules of Good Clinical Practice and national regulations)
  • Male
  • Age >= 18 years
  • Fit for operation, based on the surgeon's expert opinion
  • Isolated short (=< 3cm) bulbar urethral stricture confirmed by preoperative retrograde urethrography (RUG), voiding cysto-urethrography (VCUG), cystoscopy, ultrasonography or a combination of investigations
  • Unique urethral stricture
Show all 9Show fewer
  • Urethral stricture =< 3 cm
  • Urethral stricture at the bulbar segment
  • Patient declares that it will be possible for him to attend the follow-up consultation

Who cannot join

  • Absence of signed written informed consent
  • Age <18 years
  • Female patients
  • Transgender patients
  • Patients unfit for operation
  • Concomitant urethral strictures at other urethral locations (penile urethra, membranous urethra, prostatic urethra, bladder neck)
Show all 16Show fewer
  • Urethral strictures exceeding 3 cm
  • A unique urethral stricture at other urethral locations (penile urethra, membranous urethra, prostatic urethra, bladder neck)
  • Lichen Sclerosus related strictures
  • Strictures after failed hypospadias repair
  • Patients with neurogenic bladder
  • Shift of technique to augmented urethroplasty due to any circumstance
  • History of pelvic radiation therapy
  • Active treatment to enhance erectile function (such as PDE5-inhibitors and intracavernous injections) at the moment of prescreening for inclusion in this trial
  • Any condition or situation, which, in the investigator's opinion, puts the patient at significant risk, could confound the study results, or may interfere significantly with the patient's participation in the study
  • Patient declares that it will be impossible for him to attend the follow-up consultations

Trial locations and contacts

13 sites in 8 countries.

13 sites in 8 countries

United States2 sites
  • Department of Urology, Eastern Virginia Medical School

    Norfolk, Virginia, 23507-1912

  • Department of Urology, SUNY Upstate Medical University

    Syracuse, New York, 13210

Other trials in United States

Argentina2 sites
  • Department of Urology, Centro de Educación Médica e Investigaciones Clínicas

    Buenos Aires

  • Department of Urology, Hospital Italiano de Buenos Aires

    Buenos Aires

Other trials in Argentina

Belgium2 sites
  • Dept. of Urology, Ghent University Hospital

    Ghent, 9000

  • Dept. of Urology, University Hospital Leuven

    Leuven

Other trials in Belgium

Mexico2 sites
  • Centro de Uretra Las Alamedas

    Mexico City

  • Department of Urology, Hospital San José Tecnológico de Monterrey, Universidad de Monterrey

    Monterrey

Other trials in Mexico

Spain2 sites
  • Department of Urology, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Hospital Universitario de Getafe

    Madrid

  • Dept. of Urology, Hospital Univ. de Valdecilla

    Santander

Other trials in Spain

China1 site
  • Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital

    Shanghai

Other trials in China

Portugal1 site
  • Department of Urology, Hospital de Santa María, Universidad de Lisboa

    Lisbon

Other trials in Portugal

United Kingdom1 site
  • Department of Urology, University College London Hospital

    London

Other trials in United Kingdom

About this study

Official title: VeSpAR: A Randomized Controlled Trial Comparing Vessel-Sparing Anastomotic Repair and Transecting Anastomotic Repair in Isolated Short Bulbar Urethral Strictures

The investigators want to verify whether the surgical outcome of vessel-sparing anastomotic repair in isolated short bulbar urethral strictures is not inferior to the surgical outcome of transecting anastomotic repair. Furthermore, the investigators compare the functional outcome of both techniques verifying if there is less erectile dysfunction after vessel-sparing anastomotic repair than after transecting anastomotic repair.

Read the detailed description

A randomized controlled trial comparing vessel-sparing anastomotic repair (vsAR) and transecting anastomotic repair (tAR) in isolated short bulbar urethral strictures (maximum 3 centimeter) for both surgical and functional outcome, to demonstrate that vsAR is not inferior to tAR regarding the surgical outcome, and to demonstrate a benefit for vsAR over tAR regarding postoperative erectile function.

Being tested
Transecting anastomotic repair (tAR), Vessel-sparing anastomotic repair (vsAR)
Keywords
urethral stricture, urethroplasty, bulbar urethra, reconstructive surgery, lower urinary tract symptoms, erectile function
Medical subject headings
Urethral Stricture, Urologic Diseases, Lower Urinary Tract Symptoms

What participants receive

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

  • Transecting anastomotic repair (tAR)Procedure or surgery

    Classic technique, which involves full thickness transection of the corpus spongiosum and the embedded urethral blood supply.

  • Vessel-sparing anastomotic repair (vsAR)Procedure or surgery

    Alternative technique, leaving the bulbar arteries intact, only transecting and excising the narrow segment of the urethra and the surrounding spongiofibrosis.

Study groups in NCT03572348
Study groupRoleWhat they receive
Transecting anastomotic repair (tAR)Active comparatorClassic technique, which involves full thickness transection of the corpus spongiosum and the embedded urethral blood supply.
Receives: Procedure: Transecting anastomotic repair (tAR)
Vessel-sparing anastomotic repair (vsAR)Active comparatorAlternative technique, leaving the bulbar arteries intact, only transecting and excising the narrow segment of the urethra and the surrounding spongiofibrosis.
Receives: Procedure: Vessel-sparing anastomotic repair (vsAR)

What is being measured

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

  1. FFS at 24 months

    Failure-free survival at 24 months. Surgical failure is defined as urethroscopic evidence of stricture recurrence, impossible to pass with a 16Fr silicone urethral catheter, independent of whether the stricture is treated or not.

    Measured: 24 months

Secondary outcomes (10)
  1. FFS at 3 and 12 months

    Failure-free survival at 3 and 12 months. Surgical failure is defined as urethroscopic evidence of stricture recurrence, impossible to pass with a 16Fr silicone urethral catheter, independent of whether the stricture is treated or not.

    Measured: 3 and 12 months

  2. Erectile function

    Erectile function score assessed by the International Index of Erectile Function (IIEF-5) questionnaire

    Measured: 3, 12, and 24 months

  3. Ejaculatory function

    Ejaculatory function score assessed by the Male Sexual Health Questionnaire - Ejaculatory Dysfunction short form (MSHQ-EjD short form)

    Measured: 3, 12, and 24 months

  4. Voiding function

    Lower Urinary Tract symptoms assessed by the Peeling's voiding picture.

    Measured: 3, 12, and 24 months

  5. Lower Urinary Tract symptoms

    Lower Urinary Tract symptoms assessed by the International Consultation on Incontinence Questionnaire - Male Lower Urinary Tract Symptoms module (ICIQ-MLUTS)

    Measured: 3, 12, and 24 months

  6. Urinary incontinence

    Urinary incontinence assessed by the International Consultation on Incontinence Questionnaire - Urinary Incontinence short form (ICIQ-UI)

    Measured: 3, 12, and 24 months

  7. Maximum flow rate

    Qmax assessed using uroflowmetry

    Measured: 3, 12, and 24 months

  8. Residual urinary volumes

    Residual urinary volumes examined by suprapubic ultrasonic measurement after voiding

    Measured: 3, 12, and 24 months

  9. Quality of life (EQ-5D-3L)

    QoL scored by the EQ-5D-3L questionnaire

    Measured: 3, 12, and 24 months

  10. Quality of life (EQ-VAS)

    QoL scored by the EQ visual analogue scale (EQ-VAS)

    Measured: 3, 12, and 24 months

Timeline

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

  1. First posted28 Jun 2018
  2. Study start26 Sep 2018
  3. Primary completion14 Dec 2023
  4. Study completion14 Dec 2023

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Prospective, interventional, multicentric, single-blinded, randomized, controlled, non-inferiority, phase II trial
Masking
Single blind
Who is masked
Participant
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03572348
Sponsor's protocol ID
BC-03662
Acronym
VeSpAR
Status last verified
Jan 2024
First submitted
5 Jun 2018
Last updated
8 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Latini JM, McAninch JW, Brandes SB, Chung JY, Rosenstein D. SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries. Urology. 2014 Mar;83(3 Suppl):S1-7. doi: 10.1016/j.urology.2013.09.009. Epub 2013 Nov 8.

    PubMed 24210733
  • Palminteri E, Berdondini E, Verze P, De Nunzio C, Vitarelli A, Carmignani L. Contemporary urethral stricture characteristics in the developed world. Urology. 2013 Jan;81(1):191-6. doi: 10.1016/j.urology.2012.08.062. Epub 2012 Nov 13.

    PubMed 23153951
  • Morey AF, Watkin N, Shenfeld O, Eltahawy E, Giudice C. SIU/ICUD Consultation on Urethral Strictures: Anterior urethra--primary anastomosis. Urology. 2014 Mar;83(3 Suppl):S23-6. doi: 10.1016/j.urology.2013.11.007. Epub 2013 Dec 27.

    PubMed 24373726
  • Jordan GH, Eltahawy EA, Virasoro R. The technique of vessel sparing excision and primary anastomosis for proximal bulbous urethral reconstruction. J Urol. 2007 May;177(5):1799-802. doi: 10.1016/j.juro.2007.01.036.

    PubMed 17437823
  • Gur U, Jordan GH. Vessel-sparing excision and primary anastomosis (for proximal bulbar urethral strictures). BJU Int. 2008 May;101(9):1183-95. doi: 10.1111/j.1464-410X.2008.07619.x. No abstract available.

    PubMed 18399836
  • Lumen N, Poelaert F, Oosterlinck W, Lambert E, Decaestecker K, Tailly T, Hoebeke P, Spinoit AF. Nontransecting Anastomotic Repair in Urethral Reconstruction: Surgical and Functional Outcomes. J Urol. 2016 Dec;196(6):1679-1684. doi: 10.1016/j.juro.2016.06.016. Epub 2016 Jun 12.

    PubMed 27307398
  • Andrich DE, Mundy AR. Non-transecting anastomotic bulbar urethroplasty: a preliminary report. BJU Int. 2012 Apr;109(7):1090-4. doi: 10.1111/j.1464-410X.2011.10508.x. Epub 2011 Sep 20.

    PubMed 21933325
  • Virasoro R, Zuckerman JM, McCammon KA, DeLong JM, Tonkin JB, Capiel L, Rovegno AR, Favre G, Giudice CR, Eltahawy EA, Gur U, Jordan GH. International multi-institutional experience with the vessel-sparing technique to reconstruct the proximal bulbar urethra: mid-term results. World J Urol. 2015 Dec;33(12):2153-7. doi: 10.1007/s00345-015-1512-9. Epub 2015 Feb 18.

    PubMed 25690318
  • Bugeja S, Andrich DE, Mundy AR. Non-transecting bulbar urethroplasty. Transl Androl Urol. 2015 Feb;4(1):41-50. doi: 10.3978/j.issn.2223-4683.2015.01.07.

    PubMed 26816808
  • Anderson KM, Blakely SA, O'Donnell CI, Nikolavsky D, Flynn BJ. Primary non-transecting bulbar urethroplasty long-term success rates are similar to transecting urethroplasty. Int Urol Nephrol. 2017 Jan;49(1):83-88. doi: 10.1007/s11255-016-1454-1. Epub 2016 Nov 14.

    PubMed 27844407
  • Le W, Li C, Zhang J, Wu D, Liu B. Preliminary clinical study on non-transecting anastomotic bulbomembranous urethroplasty. Front Med. 2017 Jun;11(2):277-283. doi: 10.1007/s11684-017-0515-x. Epub 2017 Apr 22.

    PubMed 28432540
  • Andrich DE, Dunglison N, Greenwell TJ, Mundy AR. The long-term results of urethroplasty. J Urol. 2003 Jul;170(1):90-2. doi: 10.1097/01.ju.0000069820.81726.00.

    PubMed 12796652
  • Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-30. doi: 10.1002/nau.20041.

    PubMed 15227649
  • Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.

    PubMed 15273542
  • Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2.

    PubMed 19638912

Questions about this trial

What is this clinical trial studying?

A study testing Transecting anastomotic repair (tAR) and Vessel-sparing anastomotic repair (vsAR) in people with Urethral Stricture and Surgery, run by University Hospital, Ghent at 13 sites in 8 countries.

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

Who may be eligible to take part?

The sponsor lists 9 inclusion and 16 exclusion criteria. 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 8 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in United States, Argentina, Belgium, Mexico, Spain and 3 more countries. 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.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

FFS at 24 months (time frame: 24 months). 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 NCT03572348, which also lists 21 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 8 Jan 2024.

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