There are many existing treatments of female stress urinary incontinence such as the use of adult absorbent pads and diapers, behavioral training, including bladder training, pelvic muscle exercises, biofeedback, urethral plugs, intravaginal prosthesis, electrical stimulation, periurethral injections, and reconstructive surgery. However, there is still a lack of effective minimally invasive treatment options that are independent of patient compliance. One emerging approach of minimally invasive SUI therapy is pelvic floor reinforcement using laser therapy. The primary objective of this post-marketing study is to confirm the effectiveness and safety of the FotonaSmooth® device in the treatment of stress urinary incontinence (SUI) in a large number of females using objective and subjective methods. Patients with stress incontinence will be assigned to two groups, an active group, where the Fotona Dynamis Er:YAG Laser System will be used, and a sham group where a very low laser setting will be used, and parameter presentations will be masked. Participants will be adult females, 18 years old and older with clinical and urodynamic diagnosis of Stress Urinary Incontinence,who have had no significant improvement in urinary incontinence from at least one previous conservative treatment, such as behavioral measures, pelvic floor muscle training or the use of absorbent pads
Prospective, randomized, 2-treatment, sham-controlled, single (patient only) blinded, study design using convenience sampling to enroll subjects as they present and are found to be eligible per the inclusion/exclusion criteria. This multicenter clinical trial utilizes a randomized assignment allocation schedule stratified by clinical site. Allocation rule pertains to the ratio of subjects in each treatment arm. Sampling rules pertain to the number of subjects in each active treatment arm. Two treatment arms enrolled on a 2:1 ratio: Active arm is the Fotona Dynamis Er:YAG Laser System and the control arm is a sham treatment with a very low laser setting and parameter presentations masked. The active arm subjects will be followed out to 12 months post-treatment. The sham arm subjects will be followed out to 6 months and then offered the active treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
135
Treatment of urodynamic proven stress urinary incontinence using the Fotona Dynamis Er:YAG Laser System in the active arm
Sham treatment with a sham handpiece and parameter presentations masked
Lutheran Hospital Hagen-Haspe
Hagen, Germany
University of Athens, Alexandra Hospital
Athens, Greece
Cork Womens Clinic
Cork, Ireland
University Clinical Centre
Ljubljana, Slovenia
Inselspital Bern, University Hospital
Bern, Switzerland
Cantonal Hospital Frauenfeld
Frauenfeld, Switzerland
Basingstoke and North Hampshire Hospital
Basingstoke, United Kingdom
Birmingham Women's Hospital NHS foundation trust
Birmingham, United Kingdom
King's College Hospital
London, United Kingdom
Efficacy: Reduction in 1-hour pad weight between active and sham groups
Reduction in 1-hour pad weight at 6 months post-treatment in active group vs the sham treated group at 6 months post treatment
Time frame: 6 months post-treatment
Safety: Incidence and severity of device related Adverse Events
Incidence and severity of device related Adverse Events (i.e., infections, edema, superficial burns, increased vaginal discharge, de novo urge incontinence).
Time frame: 6 months post-treatment
Durability of the effect
Reduction in 1hr pad test weight in the treated group at 12 month follow-up vs. pad weight in the same group at baseline
Time frame: 12 months post-treatment
Improvement
Change in mean Cough Stress test score at 6 and 12 months post-treatment
Time frame: 6 and 12 months post-treatment
Change in King's Health Questionnaire (KHQ)
Change in mean KHQ from baseline to 6 and 12 months post-treatment
Time frame: from baseline to 6 and 12 months post-treatment.
Change in mean PISQ-12 test scores
Change in mean PISQ-12 test scores from baseline to 6 and 12 months post-treatment.
Time frame: from baseline to 6 and 12 months post-treatment.
Subjective assessment of pain
Patient reported assessment of pain during treatment
Time frame: 6 months
Change in International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) score
Change in mean ICIQ-SF from baseline to 6 and 12 months post-treatment
Time frame: from baseline to 6 and 12 months post-treatment.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.