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Trial registered on ANZCTR
Registration number
ACTRN12617001235392
Ethics application status
Approved
Date submitted
4/08/2017
Date registered
24/08/2017
Date last updated
24/08/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Prostate Artery Embolization for patients with lower urinary tract symptoms due to benign prostate hyperplasia
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Scientific title
Efficacy of Prostate Artery Embolization for patients with lower urinary tract symptoms due to benign prostate hyperplasia
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Secondary ID [1]
292593
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none
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Universal Trial Number (UTN)
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Trial acronym
PRO-FLOW
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
benign prostate hyperplasia
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lower urinary tract symptoms
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Condition category
Condition code
Renal and Urogenital
303618
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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
Prostate Artery Embolization. This procedure is performed as a day case in Interventional Radiology under conscious sedation using fluoroscopy. A very small urinary catheter is placed into the bladder and filled with contrast medium. The prostate artery is accessed using the Seldinger technique into CFA. Guidewires and catheters are introduced through the sheath and Embozene microspheres are injected into the left and right side of the prostate artery. The procedure takes approximately one hour and is performed by a specialist Interventional Radiologist. The catheter is removed 4 hours post procedure and the patient is discharged home
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Intervention code [1]
298805
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Treatment: Devices
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Intervention code [2]
298806
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Treatment: Surgery
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Comparator / control treatment
TURP group. This is the gold standard treatment for benign prostatic hyperplasia. It involves pre admission checks, ECG and anaesthetic assessment, bloods for CBC, renal, LFT and group and hold. The patient has TURP under either general or spinal anaesthetic and the procedure can take 1 -3 hours. There is significant post operative discomfort. Usually the patient has a 3-4 day hospital stay with a large urinary catheter, bladder irrigations. Patients can be discharged without or with a catheter in situ if unsuccessful trial of void immediately post op
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in IPSS after 3 months
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Assessment method [1]
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Timepoint [1]
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3 months
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Primary outcome [2]
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Successful trial of voiding after removal catheter means being able to pass urine effectively and empty bladder completely. Good stream and the ability to start and stop flow
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Assessment method [2]
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Timepoint [2]
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6 weeks
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Secondary outcome [1]
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patient satisfaction evaluations as assessed by the IPSS
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Assessment method [1]
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Timepoint [1]
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6 weeks , 6, 12, 24 and 60 months
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Eligibility
Key inclusion criteria
Willing, able and mentally competent to provide written consent
aged 40 years or older
lower urinary tract symptoms
IPSS > 8
QOL >3
Prostate gland >40g on transabdominal ultrasound
Vascular anatomy that in the opinion of the Interventional Radiologist is amenable to PAE as assessed on CTA
Adequate laboratory parameters: platelets >100 , INR <1.5, bilirubin <2, albumen >2.5, eGFR >60
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Minimum age
40
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Prior history of prostate surgery or TURP
prior radiation to the pelvis
prior embolization to the prosatate
acontractile detrusor
neurogenic lower urinary tract dysfunction
urethral stenosis
bladder stone with surgical indication
proven adenocarcinoma of the prostate
eGFR <50ml/min
complicated anatomical variant including prostate artery
ASA class 4-5
contrast allergy
significant psychiatric disorders
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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)
allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (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
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
numbers of patients recruited are based on a power calculation. For the primary endpoint, changes in IPSS at 3 months will be compared using a one sided t-test with significance level 2.5%. A non-inferiority margin has been set aside at -3. The targeted standard deviation was estimated at 3.5. If there is truly no difference between the TURP and PAE in terms of the improvement in IPSS score, the 44 patients (22 in each arm) are required to be 80% sure that the lower limit of a one sided 97.5% confidence interval (or equivalency a 95% two-sided interval) will be above the non-inferiority limit of -3.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/08/2017
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Actual
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Date of last participant enrolment
Anticipated
1/08/2019
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
44
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
9126
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Christchurch hospital
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Address [1]
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2 Riccarton Avenue
Christchurch 8011
New Zealand
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Country [1]
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New Zealand
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Primary sponsor type
Hospital
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Name
Christchurch hospital
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Address
2 Riccarton Avenue
Christchurch 8011
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health and Disability Ethics Committees
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Ethics committee address [1]
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Ministry of Health Freyberg Building 20 Aitken Street PO box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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01/06/2015
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Approval date [1]
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28/08/2015
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Ethics approval number [1]
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15/STH?119
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Summary
Brief summary
The purpose of this trial is to evaluate the safety and effectiveness of percutaneous embolization of the prostate arteries as a minimally invasive image guided procedure for patients with lower urinary tract symptoms due to benign prostate hyperplasia with a prostate volume of more than 40g. Benign prostate hyperplasia is a significant health problem in New Zealand affecting over 50% of men older than 60 years. This leads to lower urinary symptoms (LUTS) eg weak urine stream, urgency and leaking and even acute urinary retention. Symptoms are initially treated with medication but many patient do need surgical intervention. Transurethral resection of the prostate (TURP) is the standard treatment for prostates smaller than 80g whereas larger prostates may require open surgical resection. Both operations are not without risk and many elderly patients are not good candidates for surgery. Percutaneous embolization of bilateral prostate arteries aims to mimic the effect of TURP or open resection of the prostate without exposing the patients to the risk of operation and anaesthesia. PAE decrease the blood supply to the prostate gland and causes the gland to shrink. This trial aims to assess the safety and efficacy of PAE and in the future offer patients another treatment option for BPH
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Martin Krauss
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Address
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Radiology Department
Christchurch hospital
2 Riccarton Avenue
Christchurch 8011
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Country
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New Zealand
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Phone
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+64 3 3641410
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Fax
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+64 3 3641893
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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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Martin Krauss
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Address
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Radiology Department
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
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New Zealand
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Phone
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+64 3 3641410
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Fax
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+64 3 3641893
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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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Martin Krauss
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Address
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Radiology Department
Christchurch Hospital
2 Riccarton Avenue
Christchurch 8011
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Country
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New Zealand
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Phone
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+64 3 3641810
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Fax
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+64 3 3641893
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Email
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[email protected]
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No information has been provided regarding IPD availability
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
Source
Title
Year of Publication
DOI
Embase
Prostatic arterial embolization for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia.
2020
https://dx.doi.org/10.1002/14651858.CD012867.pub2
Embase
Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia: a network meta-analysis.
2021
https://dx.doi.org/10.1002/14651858.CD013656.pub2
Embase
Prostatic arterial embolization for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia.
2022
https://dx.doi.org/10.1002/14651858.CD012867.pub3
Embase
Update on the management of benign prostatic hyperplasia and the role of minimally invasive procedures.
2023
https://dx.doi.org/10.1016/j.prnil.2023.01.002
N.B. These documents automatically identified may not have been verified by the study sponsor.
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