Non-invasive neuromodulation for bladder suppression following spinal cord injury

ISRCTN ISRCTN17182264
DOI https://doi.org/10.1186/ISRCTN17182264
Secondary identifying numbers 34995
Submission date
21/08/2017
Registration date
21/08/2017
Last edited
12/12/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Spinal cord injury disrupts signals between the brain and the rest of the body, including the signals needed to voluntarily control the bladder and bowels. Following this loss in control people often experience bladder overactivity and incontinence. Currently the main treatment for this is medication, which can have side effects. Neuromodulation (a type of electrical stimulation) is a treatment which can alter nerve activity including that affecting the bladder. The aim of this study is to find out to what extent neuromodulation can reduce unwanted bladder contractions and incontinence when delivered using skin surface electrodes and a portable stimulator in people with spinal cord injury and bladder overactivity over a week in their home environment.

Who can participate?
Spinal cord injured patients aged 18 and over with overactive bladder

What does the study involve?
Participants first record a bladder diary on a provided device for one week. They then visit the clinic to test the portable stimulation system whilst their bladder's behaviour is measured, to ensure they can safely apply it by themselves and to record initial effectiveness. They use the stimulation to manage overactivity at home for one week, then visit the clinic again to re-assess its effect whilst recording bladder behaviour.

What are the possible benefits and risks of participating?
There are no direct benefits of participating. There are a few potential risks including urinary tract infections (infections of the bladder, kidneys and connecting tubes), autonomic dysreflexia (dangerous rise in blood pressure), and skin irritation from the electrodes. These risks are discussed and monitored closely during the study.

Where is the study run from?
Royal National Orthopaedic Hospital (UK)

When is the study starting and how long is it expected to run for?
September 2016 to September 2020

Who is funding the study?
Inspire Foundation (UK)

Who is the main contact?
Mr Sean Doherty
sean.doherty.15@ucl.ac.uk

Contact information

Mr Sean Doherty
Public

Royal National Orthopaedic Hospital
Brockley Hill
Stanmore
London
HA7 4LP
United Kingdom

Phone +44 (0)207 909 5605
Email sean.doherty.15@ucl.ac.uk

Study information

Study designNon-randomised; Interventional; Design type: Treatment, Device, Complementary Therapy
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Home
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleNEUROMOD: Researching the effect of electrical stimulation on bladder overactivity following spinal cord injury in a home pilot study
Study acronymNEUROMOD
Study objectivesThe purpose of this pilot study is to determine to what extent neuromodulation can reduce unwanted bladder contractions and incontinence when delivered using skin surface electrodes and a portable stimulator in people with spinal cord injury and bladder overactivity over a week in their home environment.
Ethics approval(s)Stanmore – London REC, 08/08/2017, ref: 17/LO/1031
Health condition(s) or problem(s) studiedUKCRC code/ Disease: Injuries and Accidents/ Injuries to unspecified part of trunk, limb or body region, Renal and Urogenital/ Other disorders of the genitourinary system
InterventionParticipants will first record a bladder diary on a provided device for one week. They will then visit the clinic to test the portable stimulation system whilst their bladder's behaviour is measured, this will be to ensure they can safely apply it by themselves and to record initial effectiveness. They will use the stimulation to manage overactivity at home for one week, then repeat the visit to the clinic to re-assess its effect whilst recording bladder behaviour.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureBladder overactivity, measured using bladder diary; Timepoint(s): 7 days without intervention, the 7 days with intervention
Secondary outcome measuresEffect of neuromodulation on bladder overactivity, measured using ambulatory urodynamics conducted at the beginning and at the end of the 7-day period where participants are using the stimulation device
Overall study start date14/09/2016
Completion date01/09/2020

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 12; UK Sample Size: 12
Key inclusion criteria1. Spinal cord injured
2. Aged 18 and over
3. Male or female
4. Injury sustained >6 months ago
5. Urodynamically proven neurogenic detrusor overactivity
Key exclusion criteria1. Recipient of intra-detrusor botulinum toxin injections within the last 6 months
2. Previous surgical intervention on bladder/sphincters
3. Showing positive leucocytes and nitrites on urinalysis on the day of investigation
4. Pregnancy
5. Cardiac pacemaker
6. Active sepsis
7. History of significant Autonomic Dysreflexia
8. Poorly controlled epilepsy. Acceptable where epilepsy is controlled by drugs or there have been no fits experienced for a reasonable period
9. Patients with a cancerous tumour in the area of the electrical stimulation will be excluded as increased local blood flow may increase tumour growth
10. Patients with exposed orthopaedic metal work in the area of electrical stimulation
Date of first enrolment31/08/2017
Date of final enrolment30/09/2019

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Royal National Orthopaedic Hospital
Brockley Hill
Stanmore
HA7 4LP
United Kingdom

Sponsor information

Royal National Orthopaedic Hospital NHS Trust
Hospital/treatment centre

Brockley Hill
Stanmore
London
HA7 4LP
England
United Kingdom

ROR logo "ROR" https://ror.org/03dx46b94

Funders

Funder type

Charity

Inspire Foundation
Private sector organisation / Trusts, charities, foundations (both public and private)
Location
United Kingdom

Results and Publications

Intention to publish date01/09/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in relevant peer-reviewed journal, submission of manuscript by September 2020.
IPD sharing planThe data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
HRA research summary 28/06/2023 No No

Editorial Notes

12/12/2018: The following changes were made to the trial record:
1. The recruitment end date was changed from 14/09/2018 to 30/09/2019.
2. The overall trial end date was changed from 13/09/2019 to 01/09/2020.
3. The intention to publish date was changed from 01/09/2019 to 01/09/2020.
23/08/2017: Internal edits.