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Sponsors and Collaborators: |
University Hospital, Bordeaux Ministry of Health, France |
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Information provided by: | University Hospital, Bordeaux |
ClinicalTrials.gov Identifier: | NCT00221767 |
Bladder dysfunction is a major problem in patients with complete spinal cord lesions. For patients presenting incontinence or risk for kidney, two major conventional alternatives are possible : conservative therapies (muscarinic receptor antagonists, vanilloids drugs and botulinum toxin in association with catheterization) and surgical techniques intervening in the nervous and urinary system.
Among these last alternatives, the Brindley technique (anterior sacral root stimulation with posterior rhizotomy) is the only technique allowing for the restauration of bladder function, continence, and micturition. The purpose of the study is to compare the Brindley technique with the first conventional approach in France from a medical and economical point of view.
Condition | Intervention |
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Spinal Cord Injuries Neurogenic Bladder Disorder Paraplegia Quadriplegia |
Device: Brindley technique (bladder system) |
Study Type: | Interventional |
Study Design: | Prevention, Non-Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Prospective Comparative Multicenter Study on the Medico-Economical Impact of the Brindley Technique in the Management of Neurogenic Bladder in Patients With Injured Spinal Cord |
Estimated Enrollment: | 99 |
Study Start Date: | June 2005 |
Estimated Study Completion Date: | May 2008 |
Background : In paraplegic and tetraplegic patients with suprasacral lesion, bladder overactivity leads to incontinence and is frequently associated with detrusor-sphincter dyssynergia which is responsible for residual postvoiding (high infectious risk) and intravesical high pressure (risk for kidney). The Brindley technique allows to restore a voluntary voiding of the bladder and an effective continence. Electrodes are fixed to anterior sacral roots in order to obtain micturition. Posterior sacral root rhizotomy suppress detrusor and sphincter overactivity, improves continence and thus protects bladder and kidney (low pressure bladder filling). Currently in France, 100 new patients could benefit from this innovative technique among the 1000 patients with spinal cord injury
Objective :To compare the cost/effectiveness ratio of the Brindley technique approach to that of the reference group (muscarinic receptor antagonists + catheterization or reflex micturition)at one year, in patient with neurogenic bladder.
In this prospective, comparative, non-randomized, multicenter study, the eligible patients are included according to the following ratio : 2:1 (Brindley : Reference ). The complete suprasacral spinal cord injured patients with an overactive neurogenic bladder, incontinence and/or risk of kidney/bladder injury) are the population studied. The spinal cord injury must be clinically stable for at least 3 months.
primary outcome :Proportion of patients showing a complete voluntary (including electrostimulation) micturition after one year.
Secondary outcome : Bladder capacity (cystometry), costs, incidence of urinary infections, incontinence, autonomic hyperreflexia (AHR), defecation, quality of life, lower limbs spasticity.
Patient follow-up :Visits must be planned at 1, 3, 6, 9 and 12 months: A classical clinical exam and a specific exam (evaluation of AHR, Ashworth and Penn Score) at 6 and 12 months and the following complementary exams at 3, 6 and 12 months: urodynamic testing and intravenous urography, retrograde ureterocystography and bladder echography at 12 months.
Population size : A total number of 99 patients must be enrolled to achieve the fixed goals (66 patients in the Brindley group and 33 patients in the Reference group).
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Jean-Rodolphe Vignes, Doctor | 33 (0) 5 56 79 55 43 | jean-rodolphe.vignes@chu-bordeaux.fr |
Contact: Eric Donois | 33(0) 5 56 79 55 43 | eric.donois@chu-bordeaux.fr |
France | |
Neurochirurgie A - Hôpital Pellegrin , Place Amélie Raba-Léon | Recruiting |
Bordeaux Cedex, France, 33076 | |
Contact: Jean-Rodolphe Vignes, Doctor 33 (0) 56 79 55 73 jean-rodolphe.vignes@chu-bordeaux.fr |
Principal Investigator: | Jean-Rodolphe Vignes, Doctor | University Hospital, Bordeaux |
Study Chair: | Geneviève Chêne, Professor | University Hospital, Bordeaux |
Study ID Numbers: | 9415-04, 2004-001 |
Study First Received: | September 13, 2005 |
Last Updated: | June 28, 2007 |
ClinicalTrials.gov Identifier: | NCT00221767 |
Health Authority: | France: Afssaps - French Health Products Safety Agency |
Neurogenic bladder electric stimulation therapy urinary tract infection urinary incontinence |
spinal cord injuries spinal nerve roots nonRandomized Controlled Trials open Study |
Spinal Cord Diseases Roussy Levy hereditary areflexic dystasia Urinary Tract Infections Paraplegia Disorders of Environmental Origin Quadriplegia Spinal Cord Injuries Signs and Symptoms Urologic Diseases Neuromuscular Diseases Hereditary Motor and Sensory Neuropathies Urinary Bladder, Neurogenic Cystocele |
Charcot-Marie-Tooth Disease Urinary Bladder Diseases Wounds and Injuries Central Nervous System Diseases Trauma, Nervous System Nerve Compression Syndromes Paralysis Tomaculous neuropathy Peripheral Nervous System Diseases Neurologic Manifestations Urinary Incontinence Charcot Marie Tooth disease |
Nervous System Diseases |