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Trial registered on ANZCTR
Registration number
ACTRN12611000844943
Ethics application status
Approved
Date submitted
8/08/2011
Date registered
10/08/2011
Date last updated
13/07/2021
Date data sharing statement initially provided
13/07/2021
Date results provided
13/07/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
A prospective randomised controlled trial comparing vaginal prolapse repair with and without Tensionfree Vaginal Tape (TVT) in women with severe genital prolapse and occult stress incontinence
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Scientific title
A prospective randomised controlled trial comparing vaginal prolapse repair with and without Tensionfree Vaginal Tape (TVT) in women with severe genital prolapse and occult stress incontinence: Long term follow up
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Secondary ID [1]
262776
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Treatment of occult stress urinary incontinence in conjunction with prolapse repair
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Condition category
Condition code
Surgery
270640
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0
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Surgical techniques
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Renal and Urogenital
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Insertion of TVT suburethral sling at time of prolapse repair. The TVT procedure (Gynecare, Ethicon Inc., Somerville, NJ) was performed as previously described by Ulmsten. The tape is passed from the vagina retropubically without tension. The tape is a permanent synthetic mesh. The procedure takes 10-15 min including cystoscopy to excluded any bladder perforation.
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Intervention code [1]
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Treatment: Surgery
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
The prolapse repair is performed according to surgeon preference and the participants need. The prolapse repair alone without suburethral sling insertion is the control arm.
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Control group
Active
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Outcomes
Primary outcome [1]
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Need for stress incontinence surgery after prolapse repair determined by symptomatic stress urinary incontinence as well as urodynamics stress incontinence demonstrated by the urodynamics test at 6 month follow up
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Assessment method [1]
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Timepoint [1]
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any time after primary surgery for up to 10 years
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Primary outcome [2]
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urodynamic stress incontinence at 6 month post surgery
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Assessment method [2]
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Timepoint [2]
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6 months
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Secondary outcome [1]
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subjective cure rate such as patient reports no symptoms of stress incontinence, report a numerical success score of greater than or equal to 80 out of 100, quality of life questionnaires (UDI 6 and IIQ7)
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Assessment method [1]
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Timepoint [1]
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six month and 12 months post surgery, than yearly follow up to 5 years
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Secondary outcome [2]
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intra- and post-operative complications such as haemorrhage requiring blood transfusion, visceral damage, voiding difficulty, pain (immediate at the time of surgery, short term complications in the first 6 weeks, postoperatively and long-term)
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Assessment method [2]
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Timepoint [2]
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immediate, first 6 weeks, six month and 12 months post surgery, than yearly follow up to 5 years
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Secondary outcome [3]
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urgency and urge incontinence, assessed by history and bladder diary.
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Assessment method [3]
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Timepoint [3]
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six month and 12 months post surgery, than yearly follow up to 5 years
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Eligibility
Key inclusion criteria
pelvic organ prolapse = / > Grade 2, requiring surgical correction in absence of SUI and with urodynamically demonstrated OSI. Ability to give informed consent and willingness to participate are required
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Contraindication to surgery in general such as being medically unfit for surgery, the presence of pelvic infection, malignancy, fistula, congenital or neurogenic bladder disorder, and inability to give informed consent.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomisation by phone /fax /computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomization table created by a computer software (i.e. computerised sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Randomization to either recieve the TVT suburethral sling at the time of prolapse repair or have prolapse repair alone.
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/05/2003
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Actual
2/05/2003
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Date of last participant enrolment
Anticipated
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Actual
28/08/2009
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Date of last data collection
Anticipated
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Actual
22/02/2013
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Hospital
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Name
Mercy Hospital for Women
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Address
163 Studley Road
Heidelberg
Vic 3084
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Monash Medical Centre
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Address [1]
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246 Clayton Road
Clayton
Vic 3168
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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HREC Mercy Hospital for Women
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Ethics committee address [1]
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163 Studley Rd Heidelberg , Vic 3084
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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02/05/2003
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Ethics approval number [1]
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R03/06
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Summary
Brief summary
Genital prolapse is a common condition with at least 1 woman in 10 undergoing surgery for this condition. It may be associated with urinary stress incontinence. Paradoxically, women suffering of severe genital prolapse may be continent. By reducing the prolapse during urodynamic assessment (barrier test), one can unmask urinary stress incontinence, called occult stress incontinence (OSI). Reducing the prolapse during urodynamic testing aims at mimicking the postoperative state. It is however unclear from the literature whether a positive barrier test is an indication for anti-incontinence surgery performed at the same time as prolapse surgery. Tensionfree Vaginal Tape (TVT) is an efficient anti-incontinence procedure and can be easily performed at the same time as prolapse surgery. Our study intends to randomise patients undergoing surgery for severe prolapse in two groups, one with usual prolapse surgery without any anti-incontinence procedure, the second with prolapse surgery and TVT. Urodynamics studies on patients with severe prolapse describe 36 to 80% of OSI. Our hypothesis is that 50% of patients operated for prolapse with a positive barrier test will develop urinary stress incontinence. TVT cures or improves stress incontinence in about 90% of patients. Combining TVT with prolapse surgery may therefore reduce the post-operative rate of stress incontinence from 50% to 10%. However, systematic use of TVT may expose patients to complications like voiding difficulties or de novo detrusor instability. The other option is to operate patients for prolapse and perform TVT under local anaesthesia only in those who develop distressing stress incontinence post-operatively.
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Trial website
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Trial related presentations / publications
Abstract presented at International Urogynecology Association and International Continence Society 2010 Joint Annual Scientific Meeting, August 23-27. 2010, Toronto, Canada
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Public notes
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Contacts
Principal investigator
Name
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Dr Lore Schierlitz
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Address
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Mercy Hospital for Women
163 Studley Rd
Heidelberg Vic 3084
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Country
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Australia
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Phone
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+61 3 84584890
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr. Lore Schierlitz
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Address
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Mercy Hospital for Women
163 Studley Rd
Heidelberg
Vic 3084
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Country
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Australia
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Phone
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61 3 84584890
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Lore Schierlitz
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Address
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Mercy Hospital for Women
163 Studley Rd
Heidelberg
Vic 3084
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Country
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Australia
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Phone
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61 3 84584890
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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