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NCT05685433NARecruiting

A Real World Study of eCoin for Urgency Urinary Incontinence: Post Approval Evaluation (RECIPE)

Valencia Technologies Corporation

Start Date

1/26/2023

Completion Date

12/1/2031

Summary

A prospective, multicenter, single-arm study to evaluate the safety and effectiveness of the eCoin® implanted tibial nerve stimulator in subjects with urgency urinary incontinence (UUI).

Detailed Description

The goal of this prospective, multicenter, single-arm study is to assess the long-term safety and effectiveness of the FDA approved eCoin® implanted tibial nerve stimulator in a real world setting. Eligible subjects having overactive bladder (OAB) with urgency urinary incontinence (UUI) will be implanted with the eCoin® implanted tibial stimulator and complete voiding diaries and questionnaires at follow-up visits through 5 years.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Women and men above 18 years old with gender percentages reflective of disease prevalence in the U.S. population * Individual with diagnosis of overactive bladder with urgency urinary incontinence. * Individual has at least one urgency urinary incontinence episode on each of three days as determined on a 3-day voiding diary. * Individual gives written informed consent. * Individual is mentally competent and able to understand all study requirements. * Individual is willing and able to complete a 3-day voiding diary and quality of life questionnaire. * Individual is without pharmacological treatment of overactive bladder (anticholinergic and β3-adrenoceptor agonists) for 2 weeks prior to baseline or longer if the physician judges that the therapeutic effect is still present. * Individual is intolerant of or has an inadequate response to any of anticholinergics, β3-adrenoceptor agonists, onabotulinumtoxinA, or who have undergone percutaneous tibial nerve stimulation (PTNS). * Individual is determined to be a suitable surgical candidate by physician. * Individual is appropriate for eCoin treatment based on the US FDA-approved IFU requirements. Exclusion Criteria: * Individual is not appropriate for eCoin therapy based upon the US FDA-approved IFU requirements. * Individual has clinically significant bladder outlet obstruction. (Suspected bladder outlet obstruction will be initially assessed by uroflow study with those having a maximum flow rate \< 15mL/s requiring additional evaluation.) * Individual has predominantly stress urinary incontinence (greater than 1/3 of leaks on baseline diary are stress). * Individual has an active urinary tract infection at time of enrollment. * Individual has known polyuria. * Individual has significant lower urinary tract pain or has been diagnosed with interstitial cystitis or bladder pain syndrome. * Individual has abnormal post void residual (i.e. greater than 200 cc initially and on repeat testing after double voiding) * Individual has clinically significant urethral stricture disease or bladder neck contracture. (Suspected disease or contracture will be initially assessed by uroflow study with those having a maximum flow rate \< 15mL/s requiring additional evaluation.) * Individual has chronic venous insufficiency with a history of skin change (hyperpigmentation, lipodermatosclerosis, ulceration) in the ankle region. * Individual has morbid obesity and in the opinion of the investigator is not a good candidate for the study. * Individual has had diagnosis of bladder, urethral, or prostate cancer. * Individual has had a prior anti-stress incontinence sling surgery within the last year. * Individual is pregnant or intends to become pregnant during the study. * Individual has the presence of urinary fistula, bladder stone, or interstitial cystitis. * Individual has uncontrolled diabetes mellitus (Hemoglobin A1C\>7) or diabetes with significant peripheral complications. (Uncontrolled diabetes will be ruled out by blood test excluding those with Hemoglobin A1C\>7). * Individual has an implantable neurostimulator, pacemaker, or implantable cardiac defibrillator (ICD). * Individual has been treated with onabotulinumtoxinA in the previous 9 months prior to enrollment, or more time if the principal investigator judges that the therapeutic effect is present. * Individual has been treated with percutaneous tibial nerve stimulation (PTNS) within the previous 4 weeks prior to enrollment or more time if the principal investigator judges that the therapeutic effect is present. * Individual is currently using transcutaneous electrical nerve stimulation (TENS) in the pelvic region, back, or legs. * Individual is aware that he or she will need an MRI scan other than a head/neck/shoulder MRI during the study period. * Individual has a clotting or bleeding disorder or is using anticoagulant therapies and in the opinion of the investigator is not a good candidate for the study (antiplatelet and anticoagulant therapy may be continued or held at the discretion of the investigator). * Individual is neutropenic or immune-compromised. * Individual has had previous surgery and/or significant scarring at the implant location. * Individual has ongoing dermatologic condition at the implant site, including but not limited to dermatitis and autoimmune disorders. * Individual has a clinically significant peripheral neuropathy in the lower extremities. * Individual has neurogenic bladder dysfunction. * Individual has pitting edema at implant location (≥ 2+ is excluded). * Individual has inadequate skin integrity or any evidence of an infection or inflammation in either lower leg. * Individual has varicose veins and is symptomatic. * Individual has open wounds, trauma, or prior surgery in the lower extremities. * Individual has arterial disease in the lower extremities. * Individual has vasculitis in the lower extremities. * Individual has bladder stones or neoplasia. (Suspected bladder stones or neoplasia will be ruled out with a urine dipstick showing no more than trace blood, and microscopic analysis (which should be done in that case) shows ≥3 PBC's /HPF unless that subject has been worked up and found negative for clinically significant disease such as malignant neoplasm or stones.) * In the opinion of the investigator, Individual is not a good candidate for participation in the study.

Interventions

DEVICE

eCoin Tibial Nerve Stimulation

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Conditions

Overactive BladderUrge IncontinenceIncontinence, UrinaryUrinary Urge Incontinence

Locations

Urology Centers of Alabama

Homewood, Alabama 35209

United States

USA Health

Mobile, Alabama 36606

United States

Arkansas Urology

Little Rock, Arkansas 72211

United States

University of California, Irvine

Irvine, California 92697

United States

AIR Research

Los Angeles, California 90017

United States

Stanford Health

Stanford, California 94305

United States

Urological Research Network Corp

Hialeah, Florida 33016

United States

The Emory Clinic

Atlanta, Georgia 30322

United States

Rush University

Chicago, Illinois 60612

United States

The Iowa Clinic

Ankeny, Iowa 50023

United States

University of Iowa

Iowa City, Iowa 52242

United States

University of Kansas Medical Center Research Institute, Inc

Kansas City, Kansas 66160

United States

Cypress Medical Research

Wichita, Kansas 67226

United States

Louisiana State University Health Sciences Center

Shreveport, Louisiana 71103

United States

Minnesota Urology

Woodbury, Minnesota 55125

United States

Specialty Clinical Research of St. Louis

St Louis, Missouri 63141

United States

Weill Cornell Medicine: Department of Urology

New York, New York 10065

United States

The Oregon Clinic

Portland, Oregon 97225

United States

Southern Urogynecology

West Columbia, South Carolina 29169

United States

UPNT Research Institute

Arlington, Texas 76017

United States

Baylor College of Medicine

Houston, Texas 77030

United States

The Methodist Hospital Research Institute

Houston, Texas 77030

United States