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Recurrent Urinary Tract InfectionUTIEXTERMINATENCT06124820

RCT Comparing Intravaginal Laser Therapy to Sham in Post-menopausal Women with Recurrent Urinary Tract Infections

A study testing Deka SmartXide Touch C60 (MonaLisa Touch) in people with Recurrent Urinary Tract Infection and Genitourinary Syndrome of Menopause, run by King's College Hospital NHS Trust at 1 site in United Kingdom.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Recurrent urinary tract infection (rUTI) is a common and difficult to treat problem with limited treatment option; postmenopausal women are disproportionately affected. The genitourinary syndrome of menopause (GSM) describes the broad spectrum of signs and symptoms caused by the loss of endogenous sex steroids. Read more about this study

Who is it for?
Any age, women only
What is being tested?
Deka SmartXide Touch C60 (MonaLisa Touch)
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
48 participants
Where
1 siteUnited Kingdom
Study dates
1 Oct 2023to 8 Oct 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

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 Any age
  • Women only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Postmenopausal women
  • History of recurrent UTI (Defined as women who have suffered at least three episodes of symptomatic UTI within the preceding 12 months or two episodes in the last six months, or at least one episode of UTI requiring hospitalisation, or if previously prescribed prophylactic antibiotics for UTI, have completed a 3-month washout period without antibiotic prophylaxis)
  • Able to give informed consent for participation in the trial
  • Able and willing to adhere to a 17-month study period

Who cannot join

  • Not willing to abstain from vaginal intercourse for 48 hours following laser-therapy
  • Use of vaginal hormonal therapy in the three months before study start
  • History of a genital fistula, a thin recto-vaginal septum as determined by the investigator or history of a fourth-degree laceration during physical screening exam (e.g., deficient perineal body)
  • Active sexually transmitted disease upon vaginal exam (as determined by the investigator) that precludes treatment or any other vaginal infection
  • History of lichen sclerosis
  • History of radiotherapy for cervical or uterine cancer
Show all 12Show fewer
  • A medical condition that may interfere with participants' compliance with the protocol
  • Women with correctable urinary tract abnormalities that are considered to be contributory to the occurrence of rUTI
  • Women taking Methenamine Hippurate and unable to undergo a three-month washout period
  • Undiagnosed genital bleeding
  • Women who self-catheterise, or have an indwelling/suprapubic catheter
  • Unable to give informed consent

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • King's College Hospital

    London, SE5 9RS

Other trials in United Kingdom

About this study

Official title: A Single-blinded, Randomised Controlled Trial Comparing the Use of Intravaginal Laser Therapy to Sham in Post-menopausal Women with Recurrent Urinary Tract Infections (rUTI) and the Impact on the Vaginal and Urinary Microbiome

Recurrent urinary tract infection (rUTI) is a common and difficult to treat problem with limited treatment option; postmenopausal women are disproportionately affected. The genitourinary syndrome of menopause (GSM) describes the broad spectrum of signs and symptoms caused by the loss of endogenous sex steroids. The combined effects of urogenital epithelial tissue thinning and changes to the vaginal and bladder microbiome can predispose to ascending UTIs. Recurrent UTIs is a component of GSM.

Intravaginal laser therapy has been shown to be safe and effective for the treatment of GSM, however, the role of laser for treatment of recurrent UTIs is unknown. We hypothesis that the incidence of UTI will be reduced as CO2 laser restores vaginal epithelium to a state similar to that of a pre-menopausal woman, preventing microtrauma, and increases Lactobacillus and normal flora (Athanasiou et al., 2016). Lactobacillus is considered the bacteria that helps keep the vagina healthy and infection free through its production of lactic acid which lowers vaginal pH, this more acidic environment may be protective from uropathogens.

We therefore aim to conduct a single-blinded, multi-centre, randomised controlled trial comparing the use of intravaginal CO2 laser therapy to sham in post-menopausal women with rUTIs and to determine the impact on the microbiome.

Read the detailed description

Urinary tract infections (UTIs) are the most common outpatient infection with a prevalence of 20% in women over 65, compared with 11% in the overall population (Chu and Lowder, 2018).

The genitourinary syndrome of menopause (GSM) is the accepted term used to describe the broad spectrum of genitourinary tract symptoms and signs caused by the loss of endogenous sex steroids that occurs at the time of and after the menopause. Global improvements in healthcare have resulted in an aging population. Today women are spending 40% of their lives in the postmenopausal state with 50-70% of postmenopausal women reporting symptomatic GSM. The combined effects of urogenital epithelial tissue thinning and changes to the vaginal and bladder microbiome can predispose to ascending UTIs. Recurrent UTIs is a component of GSM.

Current interventions for recurrent urinary tract infections in women include lifestyle and behavioural advice, complimentary therapies and antibiotics. These treatment regimens are not always effective or acceptable. Intravaginal Laser therapy is an alternative non-hormonal treatment of GSM as it stimulates tissue repair and restores normal vaginal function.

Currently intravaginal laser therapy has been shown to be safe and effective for the treatment of GSM, as described in a recent network analysis of 29 randomised controlled studies, incorporating 8311 patients (Li et al., 2021). Provisional results using FemTouch®, fractional CO2 laser, appear promising with 9/12 (75%) of post-menopausal women UTI free at 12 months follow-up (Yang and Foley). However, there is a scarcity of studies available looking at the impact of this novel technology for the treatment of recurrent UTIs.

The investigators aim to conduct a single-blinded, randomised controlled trial comparing the use of intravaginal CO2 laser therapy to sham in post-menopausal women with rUTIs and to determine the impact on the microbiome. The investigators hypothesise that this treatment will be effective in reducing the incidence of urinary tract infection as CO2 laser through a process of thermomodulation, simulates tissue repair by restoring vaginal epithelium to a state similar to that of a pre-menopausal woman. In addition, a study assessing the effect of micro-ablative functional CO2 laser reported an increase in Lactobacillus and normal flora (Athanasiou et al., 2016). Lactobacillus is considered the bacteria that helps keep the vagina healthy and infection free through its production of lactic acid which lowers the vaginal pH, this more acidic environment may be protective from uropathogens. The role and impact of Laser on other microbial communities is still not fully understood, this study aims to expand this knowledge base.

Recurrent UTIs is a common and difficult to treat problem with limited treatment options, this study endeavors to expand the knowledge pool and provide alternative non-pharmacological options using this novel technology.

Being tested
Deka SmartXide Touch C60 (MonaLisa Touch), Sham
Keywords
UTI, Recurrent Urinary Tract Infection, Genitourinary Syndrome of Menopause, Laser, CO2 Laser, Microbiome
Medical subject headings
Urinary Tract Infections

What participants receive

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

  • Deka SmartXide Touch C60 (MonaLisa Touch)Device

    Intravaginal micro-ablative fractional CO2 laser technology Deka SmartXide Touch C60 (MonaLisa Touch)

  • ShamDevice

    Participants receiving sham treatment will have the probes advanced in the same manner without the use of a laser energy device.

Study groups in NCT06124820
Study groupRoleWhat they receive
Treatment ArmExperimentalIntravaginal micro-ablative fractional CO2 laser technology Deka SmartXide Touch C60 (MonaLisa Touch) will be administered intravaginally over a course of 5 cycles
Receives: Device: Deka SmartXide Touch C60 (MonaLisa Touch)
Control ArmSham comparatorSham treatment -Participants receiving sham treatment will have the probes advanced in the same manner without the use of a laser energy device.
Receives: Device: Sham

What is being measured

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

  1. To determine and compare the incidence of symptomatic antibiotic-treated UTI during the 6-month follow-up period after completion of allocated treatment

    Determined from the UTI history diary and cross-referenced with hospital and GP records

    Measured: 6 months

Secondary outcomes (17)
  1. UTI history diary

    Participants will be given a UTI history diary to complete which will documents all symptomatic and treated UTI, the diary will be cross-referenced with participant history and review of medical history at each follow-up appointment.

    Measured: 18 months

  2. Vaginal Health Index Score (VHIS)

    • It incorporates a clinical examination of the vagina for pH, elasticity, fluid volume, epithelial integrity, moisture. Vaginal pH will be obtained using a piece of litmus paper placed on the lateral wall of the vagina.

    Measured: 18 months

  3. King's Health Questionnaire (KHQ)

    21 items about urinary tract symptoms yield scores in 9 domains (general health perception, incontinence impact, role limitations, physical limitations, social limitations, personal relationships, emotions, sleep/energy \& severity of symptoms).

    Measured: 18 months

  4. International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms (ICIQ-FLUTS)

    A 12 item questionnaire for evaluating female lower urinary tract symptoms

    Measured: 18 months

  5. International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS)

    A 14 item questionnaire for evaluating vaginal symptoms, associated sexual matters and impact on quality of life (QoL)

    Measured: 18 months

  6. 10 cm Visual Analogue Scale for Symptoms (VAS)

    Consists of a 10cm line, used to determine intensity of symptoms with two endpoints representing 0 ("no symptoms" and 10 ("symptom at the worse it could be"). Symptoms assessed: vaginal dryness, dyspareunia, itching, burning, dysuria, frequency, urgency, overall symptoms

    Measured: 18 months

  7. Urinary Tract Infection Symptom Assessment Questionnaire (UTISA)

    14-item questionnaire asking about the severity and bothersome of seven key UTI symptoms.

    Measured: 18 months

  8. Female Sexual Function Index Scoring (FSFI)

    A 19 item questionnaire designed to measure sexual functioning in women.

    Measured: 18 months

  9. Health Service Utilisation Questionnaire (HSU-Q)

    An instrument for the standardized and systematic assessment of various aspects of health care utilisation

    Measured: 18 months

  10. Treatment satisfaction questionnaire for laser (TSQ-L)

    A modified 10-item questionnaire used to determine participant satisfaction with treatment

    Measured: 18 months

  11. Vulvoscopic Genital Tissue Appearance Scale (VGTA)

    assesses 10 parameters of the appearance of the genital tissue including loss of labia minora/majora, decreased glans clitoris, stenosis of introitus, prominence of the urethral meatus, vestibular pallor, vestibular pallor, vesicular erythema, loss of vaginal rugae, loss of vestibular moisture and loss of prominence of the anterior vaginal wall. A score of 0 to 30 is obtained, the higher the score the worse the vulvoscopic genital tissue appearance

    Measured: 18 months

  12. Adverse event recording

    Adverse events will be asked at each visit and participant will have contact details to reports any throughout the study period

    Measured: 18 months

  13. Dipstick urine analysis

    Reagent strips used to detect substances in urine including nitrate, leucocytes, glucose, protein, pH, ketones and blood

    Measured: 18 months

  14. Standard urine culture

    Routine urinalysis that identify bacteria or yeast causing a urinary tract infection

    Measured: 18 months

  15. Expanded Quantitative Urine Culture (EQUC)

    • EQUC uses larger urine volume, longer incubation times, multiple growth media and atmospheric conditions and enables species-level identification

    Measured: 18 months

  16. 16S rRNA rapid Next-generation Gene Sequencing

    16S rRNA NGS provide gene-level information for species. It utilises PCR amplification and NGS of essential 16S ribosomal RNA genes. It enables the evaluation of even closely related bacterial species through evolutionary polymorphisms

    Measured: 18 months

  17. Shotgun metagenomic sequencing

    allows the identification and profiling of microbial species independent of reference sequences.

    Measured: 18 months

Timeline

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

  1. First posted9 Nov 2023
  2. Study start1 Oct 2023
  3. Primary completion8 Oct 2026 (estimated)
  4. Study completion8 Oct 2026 (estimated)

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
Monalisa Touch (SmartXide2 V2LR, DEKA, Florence, Italy)
Masking
Single blind
Who is masked
Participant
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06124820
Sponsor's protocol ID
302037
Acronym
UTIEXTERMINATE
Status last verified
Mar 2025
First submitted
6 Sep 2022
Last updated
10 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Will be available at request

Questions about this trial

What is this clinical trial studying?

A study testing Deka SmartXide Touch C60 (MonaLisa Touch) in people with Recurrent Urinary Tract Infection and Genitourinary Syndrome of Menopause, run by King's College Hospital NHS Trust at 1 site in United Kingdom.

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 4 inclusion and 12 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: under way, not looking for participants, as of the sponsor's last update on 10 Mar 2025. 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 United Kingdom. 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?

This study is still under way. Results are not available in the source record yet.

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?

To determine and compare the incidence of symptomatic antibiotic-treated UTI during the 6-month follow-up period after completion of allocated treatment (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 Mar 2025.

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