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Completed

NCT Number: NCT02940392

Rezum FIM Optimization Study

Evaluate the effect of the NxThera BPH Rezum System on prostate tissue in subjects suffering from LUTS symptoms secondary to benign prostatic hyperplasia (BPH).

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Key information

Age range

45 year and older

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Clinica Canela

La Romana, Dominican Republic

About this study

Subjects with BPH symptoms were treated with the Rezum device with a range of thermal energies (as measured by calorie output) to optimize the setting for maximum lesion size with minimal intra and post-procedure discomfort. Lesion size and ablated tissue resorption rate was followed post-procedure at 1 week, 1 month, 3 months, and 6 months.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male subjects > 45 years of age who have symptomatic / obstructive symptoms secondary to BPH requiring invasive intervention.
  • IPSS score of ≥ 15.
  • Qmax: Peak flow rate ≤ 15 ml/sec.
  • Post-void residual (PVR) < 300 ml.
  • Prostate transverse diameter > 30 mm.
  • Prostate volume between 20 to 120 gm.
  • Voided volume ≥ 125 ml.
  • Subject able to complete the study protocol in the opinion of the Principal Investigator.
  • Subject must be willing to undergo the procedure without anesthesia.

Exclusion criteria

  • History of any illness or surgery that in the opinion of the Principal Investigator may confound the results of the study.
  • Presence of a penile implant.
  • Any prior minimally invasive intervention (e.g. TUNA,Laser, Microwave) or surgical intervention for the symptoms of BPH.
  • Currently enrolled in another clinical trial.
  • Confirmed or suspected malignancy of prostate or bladder.
  • Previous rectal surgery (other than hemorrhoidectomy) or history of rectal disease.
  • Previous pelvic irradiation or radical pelvic surgery.
  • Documented active urinary tract infection by culture or bacterial prostatitis within last year documented by culture (UTI is defined as >100,000 colonies per ml urine from midstream clean catch or catheterization specimen).
  • Neurogenic bladder or sphincter abnormalities.
  • Urethral strictures, bladder neck contracture or muscle spasms.
  • Bleeding disorder (note that use of anti-platelet medication is not an exclusion criterion).
  • Subjects who are interested in maintaining fertility.
  • Use of concomitant (or recent) medications to include the following:
  • Beta blockers, antihistamines, anticonvulsants, and antispasmodics within 1 week of treatment, unless there is documented evidence of stable dosing for last 6 months (e.g., no dose changes).
  • Alpha blockers, antidepressants, anticholinergics, androgens, or gonadotropin-releasing hormonal analogs within 2 weeks of treatment.
  • 5-alpha reductase inhibitor within the last 6 months
  • Subject is unable or unwilling to go through a "washout" period for the above medications prior to treatment.
  • Subject has chronic urinary retention.
  • Significant urge incontinence.
  • Poor detrusor muscle function.
  • Neurological disorders which might affect bladder or sphincter function.
  • Bladder stones.
  • Renal impairment.
  • In the opinion of the Principal Investigator, subject will not be able to adequately tolerate a rigid cystoscopy-type procedure.
  • Unable or unwilling to sign the Informed Consent Form (ICF) and/or comply with all the required follow-up requirements.
  • Any cognitive disorder that interferes with or precludes a subject from directly and accurately communicating with the Principal Investigator regarding the study.
  • Peripheral arterial disease with intermittent claudication or Leriches Syndrome (i.e., claudication of the buttocks or perineum).
  • Biopsy of the prostate within 30 days prior to the Rezūm procedure.

Treatment and study plan

Rezum System

Device

The Rezūm System is designed to treat patients with bothersome urinary symptoms associated with benign prostatic hyperplasia (BPH). The Rezūm System utilizes radiofrequency current to generate "wet" thermal energy in the form of water vapor, which is then injected into the transition zone and/or median lobe of the prostate tissue in controlled 9-second doses. The vapor that is injected into the prostate tissue rapidly disperses through the interstitial space between the tissue cells. As the vapor cools, it condenses immediately on contact with tissue and the stored thermal energy is released, denaturing the cell membranes and causing cell death.

The denatured cells are absorbed by the body, which reduces the volume of prostate tissue adjacent to the urethra. The vapor condensation process also causes a rapid collapse of vasculature in the treatment zone, resulting in a bloodless procedure.

Other names: Rezum Procedure, Rezum, Water Vapor Ablation, Rezum Delivery Device, Rezum Generator

Primary outcomes

  1. Change in International Prostate Symptom Score

    Time frame: Baseline to 1 week, 1 month, 3 months, 6 months, 1 year, annually to 5 years

    International Prostate Symptom Score (IPSS) scores were recorded at Baseline to 1 week, 1 month, 3 months, 6 months, 1 year, then annually to 5 years. The mean change in IPSS was calculated.

    The IPSS is a validated questionnaire used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of benign prostatic hyperplasia (BPH). Scoring ranges from 0 to 35 with overall scores of 0-7 correlated to mildly symptomatic, 8-19 correlated to moderately symptomatic and 20-35 correlated to severely symptomatic. A reduction in score from baseline corresponds to improved outcome post procedure.

Other outcomes

  1. Intra-procedural and Post-procedural Pain

    Time frame: Procedure Day, 1 day post procedure, 1 week post procedure, 1 month post procedure, 3 months post procedure ,6 months post procedure

    Intra-procedural and post-procedural pain for each subject was assessed using the Wong Baker Pain Rating scale (0-10 with 0 indicating no pain and 10 indicating worst pain imaginable). Each subject selected the response on the pain scale that he felt best represented his pain level. Unless otherwise noted, the subjects were not given pain medications or anesthesia. All subjects were given an anti-anxiety medication plus a Non-Steroidal Anti-Inflammatory Drug (NSAID) pre-procedure.

  2. Number of Subjects Requiring Catheterization Post Procedure

    Time frame: 1 day post procedure, 1 week post procedure, 1 month post procedure

    All subjects were kept at the clinic for observation for 24 hours post-procedure. The number of subjects requiring post-procedure catheterization were recorded.

  3. Post Procedure Catheterization Duration

    Time frame: 1 month post procedure

    Measures the duration (days) of catheterization for subjects who required catheterization post procedure. Post-procedure catheterization was allowed if the Principal Investigator determined that the subject had symptoms of retention (defined as failure to void within 8 hours post procedure) or required catheterization for other safety reasons.

  4. Lesion Characteristics Via MRI (Changes in Lesion Volume)

    Time frame: 1 week , 1 month, 3 months, 6 months post procedure

    Lesion size and treated tissue resorption rate was measured by gadolinium enhanced MRI on all subjects at 1 week, 1 month, 3 months, and 6 months post-procedure. The percent change in lesion volume was calculated.

  5. Lesion Characteristics Via MRI (Changes in Prostate Volume)

    Time frame: 1 week, 1 month, 3 months, 6 months post-procedure

    Lesion size and treated tissue resorption rate was measured by gadolinium enhanced MRI on all subjects at 1 week, 1 month, 3 months, and 6 months post-procedure. The percent change in prostate volume was calculated.

  6. Lesion Characteristics Via MRI (Changes in Transition Zone Volume)

    Time frame: 1 week, 1 month, 3 months, 6 months post-procedure

    Lesion size and treated tissue resorption rate was measured by gadolinium enhanced MRI on all subjects at 1 week, 1 month, 3 months, and 6 months post-procedure. The percent change in transition (TZ) zone volume was calculated

Sponsors and collaborators

Lead sponsor

Boston Scientific Corporation

Industry

Registry information

Official study title

Rezum First in Man Feasibility Study for the Treatment of BPH With the Rezum System

Acronym: Rezum FIM

Important dates

Study start
2012
Primary completion
2017
Study completion
2017
First posted
Oct 20, 2016
Registry last updated
Mar 5, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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