The purpose of this pilot clinical study is to determine if intrasphincteric autologous myoblast injections in combination with electrical stimulation are safe and effective in treating stress urinary incontinence, confirming the optimal dose and assessing tolerability of the procedure.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Patients undergo upper arm muscle biopsy to isolate and cultivate autologous myoblasts. Using the ultrasound-directed transurethral medical device, 15-18 aliquots (50 - 100 µl per depot) of the 2 ml myoblasts/media suspension are directly injected into the urethral rhabdosphincter at two different levels. The procedure is a single-dose injection of a cell count in range of 1x106 -5x107 cells, depending of the size/quality of the biopsy and quality of outgrowing cells in order to identify possible dose related effects. To possibly enhance cell integration following implantation, a course of transvaginal electrical stimulation is undertaken.
University Medical Center Ljubljana, Dept. of Gynecology
Ljubljana, Slovenia
Change from baseline in Incontinence episode frequency (IEF)
The median percent change from baseline in IEF using the 3-day bladder diary analysis
Time frame: 6 months post-implantation
Change from baseline in Quality of Life (I-QOL) total score
Mean improvement from baseline for the Incontinence Quality of Life (I-QOL) total score
Time frame: 6 months post-implantation
Change from baseline in the Incontinence score
Time frame: 6 months post-implantation
Time to onset of response
Time to onset of response; time to maximum response; maintenance of response observed through changes in Incontinence episode frequency(IEF), Visual analog scale of the degree of suffering (VAS), Modified patient global impression of improvement(PGI-I\*), fixed bladder stress test and I-QOL.
Time frame: Up to 6 months post-implantation (based on recordings at baseline, at implantation, at 6 weeks, 3 months and 6 months post-impalntation)
Change from baseline in Fixed bladder stress test outcome
Time frame: Baseline, 6 months postimplantation.
Rate for subsequent incontinence surgery
Time frame: 6 months post-implantation
Change from baseline in Urodynamic evaluation
Cystometry, urethral pressure profile (UPP), 1-hour pad-test.
Time frame: 6 months post-implantation
Safety
Number of adverse events, patholgical lab values, vital signs and weight recordings. Number of immediate and delayed complications of cell injection, including surgical injury, scars, urinary tract infection, inflammation, pelvic pain, prolonged urinary retention, voiding dysfunction, de novo urge incontinence, hematuria, hyperplasia or tumours. Any clinically significant findings based on physical examination, standard haematology, clinical chemistry and urinalysis profiles, Electrocardiogram (ECG), Blood Pressure (BP), pulse rate and adverse events recordings.
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Time frame: Up to 6 months post-implantation
Change from baseline in Urinary incontinence semiquantitative (UIS)
Amount of leaked urine measured semiqantitative from a 3-day bladder diary.
Time frame: 6 months post-implantation