NCT01446822

Brief Summary

This is a single-center, prospective, randomized, controlled trial comparing two established transurethral electrical resection methods of urinary bladder tumors regarding their risk of stimulating the obturator nerve. One of the major safety issues with transurethral resection is bladder perforation as a consequence of obturator nerve stimulation followed by muscle contraction of. This is mostly a risk of resection of lateral bladder wall tumors near the course of the obturator nerve. It has been advocated that bipolar may be superior to monopolar resection, based on its different electrical properties. This is an important safety aspect for the patient. Main study question: In patients with lateral wall urinary bladder tumors, is bipolar superior to monopolar transurethral electroresection regarding risk of stimulation of the obturator nerve without preoperative nerve block?

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
44

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Oct 2011

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2011

Completed
2 days until next milestone

First Submitted

Initial submission to the registry

October 3, 2011

Completed
2 days until next milestone

First Posted

Study publicly available on registry

October 5, 2011

Completed
4.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2016

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2016

Completed
Last Updated

March 5, 2018

Status Verified

March 1, 2018

Enrollment Period

4.7 years

First QC Date

October 3, 2011

Last Update Submit

March 2, 2018

Conditions

Keywords

urinary bladder neoplasmbipolar transurethral resectionmonopolar transurethral resectionobturator nerve

Outcome Measures

Primary Outcomes (1)

  • Successful resection of bladder tumor

    Successful resection of the neoplasm without relevant stimulation of the obturator nerve and consecutive contraction of the ipsilateral adductor muscles

    Intraoperative

Secondary Outcomes (1)

  • Complications

    3 months

Study Arms (2)

Bipolar transurethral resection

EXPERIMENTAL
Device: Bipolar transurethral resection of the urinary bladder (PlasmaKinetic, Gyrus, Fresenius)

Monopolar transurethral resection

ACTIVE COMPARATOR
Device: Monopolar transurethral resection of the urinary bladder (Storz GmbH &Co., Erbotom, Purisole)

Interventions

Lateral wall urinary bladder tumors are resected transurethrally without obturator nerve block or relaxation under general anesthesia. If resection not possible because of adductor muscle contraction, patients undergo relaxation.

Also known as: PlasmaKinetic resectoscope, Gyrus PlasmaKinetic SuperPulse generator (Gyrus Medical Inc., Maple Grove, USA), Fresenius Natriumchlorid 9,0g/l (Fresenius Kabi AG, Homburg, Germany)
Bipolar transurethral resection

Lateral wall urinary bladder tumors are resected transurethrally without obturator nerve block or relaxation under general anesthesia. If resection is not possible because of adductor muscle contraction, patients are treated by bipolar resection. If this is still not possible, they undergo relaxation.

Also known as: Resectoscope Model 27050 (Karl Storz GmbH & Co. KG, Tuttlingen, Germany), Erbotom ICC 350 (Deltamed-ERBE AG,Winterthur, Switzerland), Purisole®SM (Fresenius Kabi AG, Homburg, Germany)
Monopolar transurethral resection

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • neoplasms of the lateral wall of the urinary bladder (laterally to the corresponding ostium)
  • operability given based on general medical condition
  • informed consent

You may not qualify if:

  • antiplatelet drugs stopped \<7days (except acetylsalicylate \<= 100mg p.o. qd)
  • prothrombine time \<70%
  • age \<18 years
  • patronized Patients
  • pregnancy
  • severe poor medical condition

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Cantonal Hospital of St.Gallen

Sankt Gallen, 9007, Switzerland

Location

Related Publications (1)

  • Gramann T, Schwab C, Zumstein V, Betschart P, Meier M, Schmid HP, Engeler DS. Transurethral resection of bladder cancer on the lateral bladder wall without obturator nerve block: extent of adductor spasms using the monopolar versus bipolar technique-a prospective randomised study. World J Urol. 2018 Jul;36(7):1085-1091. doi: 10.1007/s00345-018-2248-0. Epub 2018 Mar 1.

Related Links

MeSH Terms

Conditions

Urinary Bladder Neoplasms

Condition Hierarchy (Ancestors)

Urologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesUrinary Bladder DiseasesUrologic DiseasesMale Urogenital Diseases

Study Officials

  • Daniel S Engeler, MD

    Cantonal Hospital of St. Gallen

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Leitender Arzt, Klinik für Urologie

Study Record Dates

First Submitted

October 3, 2011

First Posted

October 5, 2011

Study Start

October 1, 2011

Primary Completion

June 1, 2016

Study Completion

September 1, 2016

Last Updated

March 5, 2018

Record last verified: 2018-03

Locations