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Interstitial CystitisNCT03987594

Comparing the Effect of Fulguration Versus Fulguration and Hydrodistension in Interstitial Cystitis/Bladder Pain Syndrome

A study testing Transurethral fulguration of the Hunner lesion and Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesion in people with Interstitial Cystitis and Bladder Pain Syndrome, run by Yonsei University at 1 site in South Korea.

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

This study is a randomized controlled trial. Subject population is adult patients with Hunner-type interstitial cystitis. The objective of this study is to compare the therapeutic effect between the two surgical modality; TUF (transurethral fulguration of the Hunner lesion) versus TUF+HD(addition of bladder… Read more about this study

Who is it for?
Ages 29 to 83 years
Conditions the study is for
Interstitial Cystitis, Bladder Pain Syndrome
What is being tested?
Transurethral fulguration of the Hunner lesion and Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesion
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
55 participants
Where
1 siteSouth Korea
Study dates
1 Aug 2015to 31 Oct 2018
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 29 to 83 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. cystoscopically proven Hunner lesion, without other demonstrable lower urinary tract diseases
  • 2. Adult patient aged more than 19 years
  • 3. Duration of IC/BPS symptom of more than 6 months
  • 4. VAS pain score more than point 4 (including point 4)
  • 5. The total score of O'Leary-Sant Interstitial Cystitis questionnaire (IC-Q) symptom and problem is more than 12 with the score of pain item is more than 2
  • 6. The total score of Pelvic pain urgency/frequency patient symptom scale more than point 13

Who cannot join

  • 1. Patient with history of bladder hydrodistension or transurethral fulguration within the period of 3 months
  • 2. Women patients who are likely to become pregnant
  • 3. Patients with average voided volume more than 400ml
  • 4. Patients with hematuria suspicious of malignancy
  • 5. Patients with microbiologically proven urinary tract infection during the screening period
  • 6. Patients with microbiologically proven recurrent urinary tract infection, more than twice during the last 6 months or more than three times of infection during the last year
Show all 15Show fewer
  • 7. Patients with previous history of genitourinary tuberculosis
  • 8. Patients with previous history of genitourinary malignancy
  • 9. Patients with previous history of bladder augmentation
  • 10. Patient with following surgery within recent 6 months at screening; hysterectomy, midureteral or suburethral sling operation, transvaginal operation, pelvic organ prolapse surgery, vaginal delivery, Caesarean section, prostate surgery, and any other treatment that might affect bladder sensation and bladder function.
  • 11. Patients with neurological diseases which might affect bladder function
  • 12. patients who rely on assisted emptying ; like clean intermittent catheterization or indwelling catheterization
  • 13. patients who are planning to rehabilitation treatment affect the bladder function, like intravesical electronic stimulation
  • 14. patient with alcohol or drug addiction
  • 15. any patient who are not fit for the study based on the investigator's decision

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Department of Urology and Urological Science Institute, Yonsei University College of Medicine

    Seoul

Other trials in South Korea

About this study

Official title: Prospective Randomized Controlled Trial Comparing the Effect of Fulguration Versus Fulguration and Hydrodistension in Interstitial Cystitis/Bladder Pain Syndrome

This study is a randomized controlled trial. Subject population is adult patients with Hunner-type interstitial cystitis. The objective of this study is to compare the therapeutic effect between the two surgical modality; TUF (transurethral fulguration of the Hunner lesion) versus TUF+HD(addition of bladder hydrodistension prior to transurethral fulguration of the Hunner lesion).

Read the detailed description

Subject patients are randomly allocated to 1:1 ratio using Permuted block randomization. For TUF group, only fulguration on the Hunner lesion is performed. For TUF+HD group hydrodistension is performed for 8 minutes at pressure of 80cmH2O, and then fulguration on the Hunner lesion is performed. Therapeutic effect is evaluated using Visual Analogue Scale (VAS) pain score, O'Leary-Sant Interstitial Cystitis questionnaire (IC-Q), Pelvic pain urgency/frequency patient symptom scale (PUF), frequency volume chart parameters, EQ-5D Health Questionnaire, Brief Pain Inventory-short form (BPI-sf), Patient Global Assessment (PGA) at the point of 1, 2, 4 and 6 months after operation. During the observational period, subject patients are not provided with any additional medical, physical or surgical treatment for symptom relief. Subject patient who complains of symptom requiring medical, physical or surgical intervention during the study period, is dropped from the study. Comparison of therapeutic efficacy between the two groups is performed using independent two sample t-test.

Being tested
Transurethral fulguration of the Hunner lesion, Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesion
Keywords
Interstitial Cystitis, Painful Bladder Syndrome, Hydrodistension, Transurethral Fulguration
Medical subject headings
Cystitis, Interstitial

What participants receive

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

  • Transurethral fulguration of the Hunner lesionProcedure or surgery

    Hunner lesion of the bladder is fulgurated with electronic surgical device under cystoscopic inspection. For the intervention, general or spinal anesthesia is required.

  • Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesionProcedure or surgery

    Prior to Hunner lesion fulguration, bladder hydrodistension is performed for 8 minutes at pressure of 80cmH2O. And then transurethral fulguration is performed on the Hunner lesion.

Study groups in NCT03987594
Study groupRoleWhat they receive
TUFPlacebo comparatorSubjects allocated into TUF+HD group receive bladder hydrodistension prior to transurethral fulguration of Hunner lesion
Receives: Procedure: Transurethral fulguration of the Hunner lesion
TUF+HDExperimentalSubjects allocated into TUF+HD group receive bladder hydrodistension prior to transurethral fulguration of Hunner lesion
Receives: Procedure: Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesion

What is being measured

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

  1. inter-group difference of VAS pain score at postoperative one month

    Primary end-point is inter-group difference of VAS pain score at postoperative one month. Analysis is performed based on independent two sample t-test. ; About the VAS pain score -'VAS' is abbreviation of 'Visual Analogue Scale'. For evaluation of pain, we use 'Visual Analogue Scale' which has a range from 0 to 10 points.

    The score increases depending on the severity of the pain symptoms.

    Measured: at postoperative one month

Secondary outcomes (25)
  1. inter-group differences in drop-out rate at postoperative 6 months

    Assessment of Drop-out rate is performed at the point of postoperative 6 months (both using the Intention-To-Treat and Per-Protocol analysis)

    Measured: at postoperative 6 months

  2. inter-group differences in O'Leary-Sant Interstitial Cystitis-Questionnaires

    O'Leary-Sant questionnaire assesses severity of symptoms on the bladder pain, frequency, urgency, nocturia, composed of symptom index and problem index

    Measured: at postoperative 1 month

  3. inter-group differences in O'Leary-Sant Interstitial Cystitis-Questionnaires

    O'Leary-Sant questionnaire assesses severity of symptoms on the bladder pain, frequency, urgency, nocturia, composed of symptom index and problem index

    Measured: at postoperative 2 months

  4. inter-group differences in O'Leary-Sant Interstitial Cystitis-Questionnaires

    O'Leary-Sant questionnaire assesses severity of symptoms on the bladder pain, frequency, urgency, nocturia, composed of symptom index and problem index

    Measured: at postoperative 4 months

  5. inter-group differences in O'Leary-Sant Interstitial Cystitis-Questionnaires

    O'Leary-Sant questionnaire assesses severity of symptoms on the bladder pain, frequency, urgency, nocturia, composed of symptom index and problem index

    Measured: at postoperative 6 months

  6. inter-group differences in PUF(Pelvic pain and Urgency/Frequency patient symptom scale)

    PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is questionnaire which evaluates symptoms of pain, urgency, and frequency and how much they bother the patient. PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is composed of two compartment; symptom score (7 items) and bother score (4 items). The symptom scores range from 2~23 points and the symptom scores range from 0~12 points. The higher the score, the worse the symptoms.

    Measured: at postoperative 1 month

  7. inter-group differences in PUF(Pelvic pain and Urgency/Frequency patient symptom scale)

    PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is questionnaire which evaluates symptoms of pain, urgency, and frequency and how much they bother the patient. PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is composed of two compartment; symptom score (7 items) and bother score (4 items). The symptom scores range from 2~23 points and the symptom scores range from 0~12 points. The higher the score, the worse the symptoms.

    Measured: at postoperative 2 months

  8. inter-group differences in PUF(Pelvic pain and Urgency/Frequency patient symptom scale)

    PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is questionnaire which evaluates symptoms of pain, urgency, and frequency and how much they bother the patient. PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is composed of two compartment; symptom score (7 items) and bother score (4 items). The symptom scores range from 2~23 points and the symptom scores range from 0~12 points. The higher the score, the worse the symptoms.

    Measured: at postoperative 4 months

  9. inter-group differences in PUF(Pelvic pain and Urgency/Frequency patient symptom scale)

    PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is questionnaire which evaluates symptoms of pain, urgency, and frequency and how much they bother the patient. PUF (Pelvic pain and Urgency/Frequency patient symptom scale) is composed of two compartment; symptom score (7 items) and bother score (4 items). The symptom scores range from 2~23 points and the symptom scores range from 0~12 points. The higher the score, the worse the symptoms.

    Measured: at postoperative 6 months

  10. inter-group differences in EQ-5D Health Questionnaire

    The EQ-5D questionnaire is a tool for brief evaluation of subject's health status. The EQ-5D questionnaire has five dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item has three-level; having no problems, having some or moderate problems, being unable to do/having extreme problems. Rated level can be coded as a number 1, 2, or 3, which indicates having no problems for 1, having some problems for 2, and having extreme problems for 3. As a result, a person's health status can be defined by a 5-digit number. The 5-digit number is finally converted to a single summary index by a specific formula.

    Measured: at postoperative 1 month

  11. inter-group differences in EQ-5D Health Questionnaire

    The EQ-5D questionnaire is a tool for brief evaluation of subject's health status. The EQ-5D questionnaire has five dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item has three-level; having no problems, having some or moderate problems, being unable to do/having extreme problems. Rated level can be coded as a number 1, 2, or 3, which indicates having no problems for 1, having some problems for 2, and having extreme problems for 3. As a result, a person's health status can be defined by a 5-digit number. The 5-digit number is finally converted to a single summary index by a specific formula.

    Measured: at postoperative 2 months

  12. inter-group differences in EQ-5D Health Questionnaire

    The EQ-5D questionnaire is a tool for brief evaluation of subject's health status. The EQ-5D questionnaire has five dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item has three-level; having no problems, having some or moderate problems, being unable to do/having extreme problems. Rated level can be coded as a number 1, 2, or 3, which indicates having no problems for 1, having some problems for 2, and having extreme problems for 3. As a result, a person's health status can be defined by a 5-digit number. The 5-digit number is finally converted to a single summary index by a specific formula.

    Measured: at postoperative 4 months

  13. inter-group differences in EQ-5D Health Questionnaire

    The EQ-5D questionnaire is a tool for brief evaluation of subject's health status. The EQ-5D questionnaire has five dimensions; mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item has three-level; having no problems, having some or moderate problems, being unable to do/having extreme problems. Rated level can be coded as a number 1, 2, or 3, which indicates having no problems for 1, having some problems for 2, and having extreme problems for 3. As a result, a person's health status can be defined by a 5-digit number. The 5-digit number is finally converted to a single summary index by a specific formula.

    Measured: at postoperative 6 months

  14. Brief Pain Inventory-short form (BPI-sf)

    Brief Pain Inventory-short form (BPI-sf) is composed of two domains measured by the "pain severity" and the "pain interference", Pain severity compartment is composed of 4 items, and pain interference compartment is composed of 7 items (of 24-hour recall period). Each item has 0-10 scales. Brief pain severity score is calculated by adding the scores of 4 questions and then dividing by 4. Brief pain interference score is calculated by adding the scores for 7 questions and then dividing by 7.

    Measured: at postoperative 1 month

  15. Brief Pain Inventory-short form (BPI-sf)

    Brief Pain Inventory-short form (BPI-sf) is composed of two domains measured by the "pain severity" and the "pain interference", Pain severity compartment is composed of 4 items, and pain interference compartment is composed of 7 items (of 24-hour recall period). Each item has 0-10 scales. Brief pain severity score is calculated by adding the scores of 4 questions and then dividing by 4. Brief pain interference score is calculated by adding the scores for 7 questions and then dividing by 7.

    Measured: at postoperative 2 months

  16. Brief Pain Inventory-short form (BPI-sf)

    Brief Pain Inventory-short form (BPI-sf) is composed of two domains measured by the "pain severity" and the "pain interference", Pain severity compartment is composed of 4 items, and pain interference compartment is composed of 7 items (of 24-hour recall period). Each item has 0-10 scales. Brief pain severity score is calculated by adding the scores of 4 questions and then dividing by 4. Brief pain interference score is calculated by adding the scores for 7 questions and then dividing by 7.

    Measured: at postoperative 4 months

  17. Brief Pain Inventory-short form (BPI-sf)

    Brief Pain Inventory-short form (BPI-sf) is composed of two domains measured by the "pain severity" and the "pain interference", Pain severity compartment is composed of 4 items, and pain interference compartment is composed of 7 items (of 24-hour recall period). Each item has 0-10 scales. Brief pain severity score is calculated by adding the scores of 4 questions and then dividing by 4. Brief pain interference score is calculated by adding the scores for 7 questions and then dividing by 7.

    Measured: at postoperative 6 months

  18. Patient Global Assessment (PGA)

    Patient Global Assessment (PGA) is composed of a single questionnaire assessing the subjective patients-reported outcome. The question is "How is your bladder condition today?". The patients choose one of the following five answers; very-good, god, moderate, bad, very bad.

    Measured: at postoperative 1 month

  19. Patient Global Assessment (PGA)

    Patient Global Assessment (PGA) is composed of a single questionnaire assessing the subjective patients-reported outcome. The question is "How is your bladder condition today?". The patients choose one of the following five answers; very-good, god, moderate, bad, very bad.

    Measured: at postoperative 2 months

  20. Patient Global Assessment (PGA)

    Patient Global Assessment (PGA) is composed of a single questionnaire assessing the subjective patients-reported outcome. The question is "How is your bladder condition today?". The patients choose one of the following five answers; very-good, god, moderate, bad, very bad.

    Measured: at postoperative 4 months

  21. Patient Global Assessment (PGA)

    Patient Global Assessment (PGA) is composed of a single questionnaire assessing the subjective patients-reported outcome. The question is "How is your bladder condition today?". The patients choose one of the following five answers; very-good, god, moderate, bad, very bad.

    Measured: at postoperative 6 months

  22. frequency volume chart parameters

    frequency volume chart is a tool for assessment of micturition time, volume of urination and urgency episode. 24-hr frequency of micturition, maximum voided volume, episode of urgency, and nocturia is evaluated.

    Measured: at postoperative 1 month

  23. frequency volume chart parameters

    frequency volume chart is a tool for assessment of micturition time, volume of urination and urgency episode. 24-hr frequency of micturition, maximum voided volume, episode of urgency, and nocturia is evaluated.

    Measured: at postoperative 2 months

  24. frequency volume chart parameters

    frequency volume chart is a tool for assessment of micturition time, volume of urination and urgency episode. 24-hr frequency of micturition, maximum voided volume, episode of urgency, and nocturia is evaluated.

    Measured: at postoperative 4 months

  25. frequency volume chart parameters

    frequency volume chart is a tool for assessment of micturition time, volume of urination and urgency episode. 24-hr frequency of micturition, maximum voided volume, episode of urgency, and nocturia is evaluated.

    Measured: at postoperative 6 months

Timeline

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

  1. First posted17 Jun 2019
  2. Study start1 Aug 2015
  3. Primary completion31 Oct 2018
  4. Study completion31 Oct 2018

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
1:1 allocation with Permuted block randomization
Masking
None (open label)
Enrolment
55 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03987594
Sponsor's protocol ID
4-2015-0492
Other IDs
2016-12-007-001
Status last verified
Aug 2019
First submitted
13 Jun 2019
Last updated
3 Sep 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Currently, we do not plan to share patient data with third parties.

Publications

  • Malde S, Palmisani S, Al-Kaisy A, Sahai A. Guideline of guidelines: bladder pain syndrome. BJU Int. 2018 Nov;122(5):729-743. doi: 10.1111/bju.14399. Epub 2018 Jun 13.

    PubMed 29777618
  • Kirk PS, Santiago-Lastra Y, Qin Y, Stoffel JT, Clemens JQ, Cameron AP. The effects of cystoscopy and hydrodistention on symptoms and bladder capacity in interstitial cystitis/bladder pain syndrome. Neurourol Urodyn. 2018 Aug;37(6):2002-2007. doi: 10.1002/nau.23555. Epub 2018 Mar 22.

    PubMed 29566264
  • Bosch PC. A Randomized, Double-blind, Placebo-controlled Trial of Certolizumab Pegol in Women with Refractory Interstitial Cystitis/Bladder Pain Syndrome. Eur Urol. 2018 Nov;74(5):623-630. doi: 10.1016/j.eururo.2018.07.026. Epub 2018 Jul 30.

    PubMed 30072210
  • Akiyama Y, Niimi A, Nomiya A, Yamada Y, Nakagawa T, Fujimura T, Fukuhara H, Kume H, Igawa Y, Homma Y. Extent of Hunner lesions: The relationships with symptom severity and clinical parameters in Hunner type interstitial cystitis patients. Neurourol Urodyn. 2018 Apr;37(4):1441-1447. doi: 10.1002/nau.23467. Epub 2018 Jan 9.

    PubMed 29315774
  • Son HS, Yoon H, Lee HS, Kim JH. Prospective randomized controlled trial comparing fulguration versus fulguration and hydrodistension for Hunner-type interstitial cystitis/bladder pain syndrome. World J Urol. 2022 Aug;40(8):2071-2076. doi: 10.1007/s00345-022-04062-8. Epub 2022 Jun 15.

    PubMed 35704106

Questions about this trial

What is this clinical trial studying?

A study testing Transurethral fulguration of the Hunner lesion and Combination treatment of bladder hydrodistension and transurethral fulguration of the Hunner lesion in people with Interstitial Cystitis and Bladder Pain Syndrome, run by Yonsei University at 1 site in South Korea.

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 6 inclusion and 15 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 3 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Korea. 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. Some participants in this study may receive a placebo. 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?

inter-group difference of VAS pain score at postoperative one month (time frame: at postoperative one month). 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 NCT03987594, which also lists 5 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 3 Sep 2019.

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