CClinicalTrials.gg
Status unknownNCT03295253Updated Sep 27, 2017

Fat Grafting Technique Using Autologous Adipose Tissue Lipogems in Patients Suffering From Stress Urinary Incontinence

An interventional study of Autologous adipose tissue harvesting/grafting using Lipogems in Urinary Incontinence,Stress, sponsored by The Miriam Hospital. Status unknown at 1 site in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-09-27.

Sponsored by The Miriam Hospital · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Sep 2017), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
01

Study summary

Urinary incontinence affects more than 200 million people worldwide. In women, childbirth or menopausal aging atrophic vagina, lack of estrogen stimulation of muscular turgor of the vagina, decrease tone of the urogenital diaphragm, attenuation and weakening of the urethral sphincter all result in stress incontinence, urge incontinence and sometimes mixed incontinence respectively.

The purpose of this study is to evaluate reconstructive lipoplasty with micro-fragmented autologous adipose tissue (Lipogems®) in female patients with stress urinary incontinence. This is a prospective study of 25 subjects that will be evaluated over a period of one year.

The treatment consist of the injection of micro fragmented adipose tissue, previously extracted from the patient in the area of the urethral sphyncter.

Patients will have follow ups at 6 months with Urodynamic studies to measure the pre-post injection differences to-date. Visual analog score questionnaire and report in subjective improvement, pad use and stress cough test will be documented at 1, 3, 6, and 12 months follow-up.

Read the detailed description

Urinary incontinence affects more than 200 million people worldwide. In women, childbirth or menopausal aging atrophic vagina, lack of estrogen stimulation of muscular turgor of the vagina, decrease tone of the urogenital diaphragm, attenuation and weakening of the urethral sphincter all result in stress incontinence, urge incontinence and sometimes mixed incontinence respectively. The purpose of this study is to evaluate reconstructive lipoplasty with micro-fragmented autologous adipose tissue (Lipogems®) in female patients with stress urinary incontinence. This is a prospective study of 25 subjects that will be evaluated over a period of one year.

Different available treatments for stress urinary incontinence (SUI) are surgical: MMK, R A Z, Burch, (TOT, T VT-mesh sling) and urethral bulking agents. New treatments using mesenchymal stem cells have been tested for the last eight years and now moved from animal models to humans with positive results.

Subjects will receive a full history and examination by a single urologist. A clear history of their incontinence pattern, the amount of incontinence based on PAD counts, under what conditions incontinence occurs to categorize type of incontinence for the female patient pre- or post-menopause. Childbirth history, age of onset, time of occurrence, predisposing factors, medications, hormones, etc. all patients will be registered and categorized according to incontinence.

The patients will receive reconstructive lipoplasty with micro-fragmented autologous adipose tissue (Lipogems®).

Subjects will log their results immediately post injection and then daily for up to two years noting any changes they've noticed in their presenting problems. At 6 months Urodynamic studies will be performed to measure the pre-post injection differences to-date. Visual analog score questionnaire and report in subjective improvement, pad use and stress cough test will be documented at 1, 3, 6, and 12 months follow-up.

02

Conditions studied

  • Urinary Incontinence,Stress

Keywords

  • urinary incontinence
  • stress urinary incontinence
  • stress incontinence
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

Female patients with:

  1. stress incontinence (SUI)
  2. mixed urinary incontinence (SUI main component)
  3. Intrinsic Sphincter Deficiency (ISD)

Exclusion criteria

Exclusion Criteria:

  1. Present diagnosis of cancer (not in remission)
  2. Patients with uncorrected vaginal prolapse (cystocele or utero/bladder prolapse)
  3. Incontinence of unknown etiology (other medical reasons) overflow incontinence
  4. Patients with neurogenic bladder
  5. Any patients unable to give informed consent, including members of vulnerable populations
  6. Patients with concomitant pelvic floor disorders, like interstitial cystitis or pelvic floor dysfunction
  7. Vulvar dermatosis, herpes simplex or active or recurrent urinary tract infection
  8. Patients with chronic steroid use
  9. Patients 17 and under
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    Female patients with Stress Incontinence

    Female patients who will undergo autologous adipose tissue harvesting/grafting using Lipogems and grafting in urethra/bladder neck

    Procedure: Autologous adipose tissue harvesting/grafting using Lipogems

Interventions

  • ProcedureAutologous adipose tissue harvesting/grafting using Lipogems

    Adipose tissue harvesting and grafting in the urethra using fat micro-fragmentation and processing device Lipogems

05

What researchers measure

Primary outcomes

  1. Resolution of Stress urinary Incontinence Measured by patient reported outcomes on questionnaire

    Comparison of pre and post procedure patient reported outcomes questionnaire

    Time frame: 2 years

  2. Resolution of Stress urinary Incontinence Measured by patient outcomes on Urodynamic Studies

    Comparison of pre and post procedure patient Urodynamic studies

    Time frame: 2 years

  3. Resolution of Stress urinary Incontinence Measured by patient reported pad count

    Comparison of pre and post procedure patient pad count

    Time frame: 2 years

  4. Resolution of Stress urinary Incontinence Measured by patient cough stress test

    Comparison of pre and post procedure patient cough stress test

    Time frame: 2 years

Other outcomes

  1. Incidence of treatment related adverse events

    site-reported adverse events designated as related to the treatment

    Time frame: 2 years

06

Study locations

1 of 1 sites recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03295253
Lead sponsor
The Miriam Hospital
Responsible party
Janice Santos Cortes (Assistant Professor of Surgery (Urology), The Miriam Hospital) — Principal investigator
First posted
Sep 27, 2017
Start date
Dec 15, 2016
Primary completion
Dec 15, 2018 (estimated)
Completion
Dec 15, 2018 (estimated)
Last update
Sep 27, 2017

Study contacts

Janice Santos, MD
Contact
janice.santos-cortes@lifespan.org
401-421-0710 ext. 1321
Patrizia Curran, MD
Contact
pcurran1@lifespan.org
401-793-7824
Janice Santos, MD
principal investigator · Women Medicine Collaborative/The Miriam Hospital
Patrizia Curran, MD
study director · The Miriam Hospital/ Women Medicine Collaborative

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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