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Benign Prostatic HyperplasiaQUAPELLANCT01534793

QUAPELLA (QUAlity of Prostate Enucleation by LUMENIS - Laser)

An observational study of Benign Prostatic Hyperplasia, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This observational study aims at describing the learning curve of the Holmium Enucleation of the Prostate (HoLEP) technique using a LUMENIS laser device by senior attending urologists. Read more about this study

Who is it for?
Ages 50 years and older, men only
Conditions the study is for
Benign Prostatic Hyperplasia
What is being tested?
Holmium Laser Enucleation of the Prostate (HoLEP)
How many people
100 participants
Where
1 siteFrance
Study dates
Feb 2012to Jul 2014
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Study population: Patient presenting low urinary tract symptoms due to benign prostatic hyperplasia

Who may be able to join

  • Male patients over 50
  • Classification of risk according to the American Society of Anesthesiologists (ASA) score: score 1, 2 or 3
  • Protocol accepted by patient (signed informed consent)
  • Patient presenting low urinary tract symptoms due to benign prostatic hyperplasia, since at least 3 months, with indication of surgical relief of bladder outlet obstruction , with International prostate symptom score (I-PSS)≥ 12 and a bother score ≥ 3, or full bladder retention, drained by a catheter or suprapubic catheter
  • Patient with maximum urinary flow rate ≤ 12mL/s for a voiding volume ≥ 125mLat uroflowmetry, for patients who are not drained
  • Prostate weight between 40 and 80 grams
Show all 15Show fewer
  • Post void residual volume ≤ 300cc, for patients who are not drained
  • Normal renal function
  • Non suspect digital rectal examination
  • PSA value et blood test £ 4 ng/ml, or negative prostatic biopsies if PSA comprised between 4 and 10 ng/ml for patients with age < 75 and life expectancy > 10 years
  • Patient under oral anticoagulation therapy if a therapeutic switch is possible and validated by both the anaesthesiologist and the prescription of the anticoagulation therapy
  • Patient under under antiplatelet agents if this treatment can be interrupted without replacement therapy 5 days prior to surgery without any increased risk for the patient safety
  • Patient gave informed consent and is not opposed to the use of the data collected during the study for research purpose
  • Patient treated by BPH drugs if the duration and type are known, and if the treatment has been stopped before the intervention (one week before surgery for plants and alpha-blockers, one week for 5-alpha reductase inhibitors)
  • Patients has valid health insurance/coverage.

Who cannot join

  • Patients with unstable known cardiac or pulmonary disease
  • Patients with severe myasthenia, multiple sclerosis, Parkinson disease with known bladder or urinary sphincter dysfunction.
  • Patient with history of severe pelvic injury having caused severe external urinary sphincter damage.
  • Patient with active urinary tract infection
  • Patient with urinary catheter or a suprapubic catheter for a reason other than acute urinary retention due to benign prostatic hyperplasia or experiencing no need to urinate after an event filling than 300cc
  • Patient with neurogenic disease of the urinary tract
Show all 15Show fewer
  • Patient with known or suspected malignant lesion of the bladder or the prostate
  • Patient with history of previous prostatic surgery
  • Patient with history of bladder stone, major hematuria, urethral stricture, bladder neck stenosis, bladder disease or diabetes with bladder impairment
  • Patient with a prosthesis or material in the region potentially affected by the surgical procedure.
  • Patient with ano-rectal disease
  • Cases where the surgical indication is decided in an emergency context
  • Patient with predictable incomplete follow-up
  • Patient with coagulation disease or abnormalities not covered by the drugs belonging to the categories cited in inclusion criteria 11 and 12
  • All patient condition that the investigator considers as an exclusion criterion

Trial locations and contacts

1 site in 1 country.

France1 site
  • Service Urologie - Hôpital Tenon

    Paris, Île-de-France Region, 75020

Other trials in France

About this study

Official title: Observational Study Evaluating the Quality of Laser Enucleation of the Prostate Using a LUMENIS Laser Device

This observational study aims at describing the learning curve of the Holmium Enucleation of the Prostate (HoLEP) technique using a LUMENIS laser device by senior attending urologists.

Read the detailed description

This is a prospective, multicentre observational study studying the learning curve of the HoLEP procedure, through auto-evaluation of the quality of the surgery by senior attending urologists introducing HoLEP in their current clinical practice. This is a single arm, not comparative study. The primary outcome is the ability of each surgeon to perform 4 HoLEP procedures successfully, according to a pre-defined surgical performance scale [varying from 0 to 5]. To be successful, a procedure must be scored 5/5. Each procedure is evaluated at the end of the surgical act by the surgeon himself. As secondary outcomes, the short term efficacy and safety parameters of the HoLEP technique will be evaluated through the following data prospectively collected:

  • I-PSS symptom score (15 days before operation, at 6 and 12 months postoperative)
  • I-PSS bother score (15 days before operation, at 1, 6 and 12 months postoperative)
  • DAN-PSSsex score (15 days before operation, at 6 and 12 months postoperative)Global sexual satisfaction (15 days before operation, at 6 and 12 months postoperative)
  • Quality of life score QoL-Europe (15 days before operation, and at 12 months postoperative)
  • Urinary flow rate I-PSS symptom score (15 days before operation, at day 0, and at 1, 6 and 12 months postoperative)
  • Postvoid residual volume (15 days before operation, at day 0, and at 1, 6 and 12 months postoperative)
  • Ultrasound examination of the prostate (15 days before operation, at 6 and 12 months postoperative)
  • PSA blood testing (15 days before operation, at 6 and 12 months postoperative)One month post-operative questionnaire at one month post-operative
  • Evaluation of adverse events (the day of operation, at 1, 6 and 12 months postoperative)
  • Satisfaction of the intervention (at 1 and 12 months postoperative)
  • Pathologic examination of the prostate tissue (at 1 months postoperative)
  • Blood levels of sodium, haemoglobin, and haematocrit (15 days before intervention, immediately after intervention,)

Time needed for each step of the procedure:

  • prostatic capsule contact
  • enucleation of the median lobe
  • enucleation of the lateral lobes
  • hemostasis
  • morcellation Laser data (duration, Joules number number of fibers used, fibre type, morcellator ans nephroscope type)
  • Tissue weight
  • Irrigation volume
  • Need for coagulation with another device
  • Adverse events during the procedure
  • Type of catheter after surgery
  • Duration of the catheterization
  • Post-operative irrigation (duration, volume, type)
  • Hospital stay. The indications of the surgery are the usual indications for bladder outlet obstruction relief in ta context of low urinary tract symptoms due to benign prostatic hyperplasia, as an alternative to the other level 1
  • Grade A recommended surgical techniques. The profile of every surgeon will be recorded in terms of surgical experience with age, number of previous endoscopic prostatic surgical procedures, number of laser procedures.

The study design is scheduled as follows:

  • Inclusion visit (between D-25 and D-5 before surgery), for inclusion written informed consent as assessment of baseline data
  • Surgical intervention (D0): performed as previously described in the literature, with assessment of perioperative data
  • One month visit: one month data
  • Six month visit: six months data
  • One year visit: one year data Statistical analysis will be conducted under SAS9.2 as descriptive analysis for all data, CUSUM technique for main outcome criterion (Altman et al. Stat Med 1988 7 : 629-637 and modelisation of the learning curve.
Being tested
Holmium Laser Enucleation of the Prostate (HoLEP)
Keywords
Quality assessment, Benign Prostatic Hyperplasia, Enucleation of the prostate, LUMENIS, Laser, Learning Curve
Medical subject headings
Prostatic Hyperplasia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Holmium Laser Enucleation of the Prostate (HoLEP)Procedure or surgery

    Under regional or general anaesthesia Urethroscopy to check the location of the prostatic capsule Enucleation of the prostatic lobes (median if present, then lateral lobes)Hemostasis Morcellation Device : LUMENIS Laser

Study groups in NCT01534793
Study groupRoleWhat they receive
HoLEPHolmium Laser Enucleation of the Prostate
Receives: Procedure: Holmium Laser Enucleation of the Prostate (HoLEP)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The primary outcome is the ability of each surgeon to perform 4 HoLEP procedures successfully, according to a pre-defined surgical performance scale [varying from 0 to 5].

    The primary outcome is the ability of each surgeon to perform 4 HoLEP procedures successfully, according to a pre-defined surgical performance scale [varying from 0 to 5]. To be successful, a procedure must be scored 5/5. Each procedure is evaluated at the end of the surgical act by the surgeon himself.

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

Secondary outcomes (25)
  1. I-PSS symptom score (15 days before operation, at 6 and 12 months postoperative)

    Measured: 15 days before operation, at 6 and 12 months postoperative)

  2. I-PSS bother score (15 days before operation, at 1, 6 and 12 months postoperative)

    Measured: 15 days before operation, at 1, 6 and 12 months postoperative

  3. DAN-PSSsex score (15 days before operation, at 6 and 12 months postoperative)

    Measured: 15 days before operation, at 6 and 12 months postoperative

  4. Global sexual satisfaction (15 days before operation, at 6 and 12 months postoperative)

    Measured: 15 days before operation, at 6 and 12 months postoperative

  5. Quality of life score QoL-Europe (15 days before operation, and at 12 months postoperative)

    Measured: 15 days before operation, and at 12 months postoperative

  6. Urinary flow rate I-PSS symptom score (15 days before operation, at day 0, and at 1, 6 and 12 months postoperative)

    Measured: 15 days before operation, at day 0, and at 1, 6 and 12 months postoperative

  7. Postvoid residual volume (15 days before operation, at day 0, and at 1, 6 and 12 months postoperative)

    Measured: 15 days before operation, at day 0, and at 1, 6 and 12 months postoperative

  8. Ultrasound examination of the prostate (15 days before operation, at 6 and 12 months postoperative)

    Measured: 15 days before operation, at 6 and 12 months postoperative

  9. PSA blood testing (15 days before operation, at 6 and 12 months postoperative)

    Measured: 15 days before operation, at 6 and 12 months postoperative

  10. One month post-operative questionnaire

    Measured: at 1 month

  11. Evaluation of adverse events (the day of operation, at 1, 6 and 12 months postoperative)

    Measured: the day of operation, at 1, 6 and 12 months postoperative

  12. Satisfaction of the intervention (at 1 and 12 months postoperative)

    Measured: at 1 and 12 months postoperative

  13. Pathologic examination of the prostate tissue

    Pathologic examination of the prostate tissue (at 1 month postoperative)

    Measured: at 1 month postoperative

  14. Blood levels of sodium, haemoglobin, and haematocrit (15 days before intervention, immediately after intervention,)

    Measured: 15 days befor intervention, immediately after intervention

  15. Intervention duration

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  16. Time needed for each step of the procedure

    Time needed for each step of the procedure:

    • prostatic capsule contact
    • enucleation of the median lobe
    • enucleation of the lateral lobes
    • hemostasis
    • morcellation

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  17. Laser data

    Laser data (duration, Joules number number of fibers used, fibre type, morcellator ans nephroscope type)

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  18. Tissue weight

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  19. Irrigation volume

    Measured: participants will be followed for the duration of hospital stay, an expected average of 1,5 days

  20. Need for coagulation with another device

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  21. Adverse events at the day of operation, at 1, 6,12 months post-operative

    Measured: the day of operation, at 1, 6,12 months post-operative

  22. Type of catheter at the surgery

    Measured: participants will be followed for the duration of the intervention, an expected average of 1 hour

  23. Duration of the catheterization

    Measured: participants will be followed for the duration of hospital stay, an expected average of 1,5 days

  24. Post-operative irrigation (duration, volume, type)

    Measured: participants will be followed for the duration of hospital stay, an expected average of 1,5 days

  25. Hospital stay

    Measured: participants will be followed for the duration of hospital stay, an expected average of 1,5 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Feb 2012 (estimated)
  2. Study startFeb 2012
  3. Primary completionMay 2013
  4. Study completionJul 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01534793
Sponsor's protocol ID
K070301 / IC0709
Other IDs
2008-A-00498-47
Acronym
QUAPELLA
Status last verified
Feb 2015
First submitted
25 Jan 2012
Last updated
25 Feb 2015
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

An observational study of Benign Prostatic Hyperplasia, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Feb 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The primary outcome is the ability of each surgeon to perform 4 HoLEP procedures successfully, according to a pre-defined surgical performance scale [varying from 0 to 5]. (time frame: participants will be followed for the duration of the intervention, an expected average of 1 hour). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Feb 2015.

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