Effect of Peri-Urethral Stimulation on Intra-Urethral Pressure

Last updated: June 25, 2025
Sponsor: William Beaumont Hospitals
Overall Status: Active - Recruiting

Phase

N/A

Condition

Enuresis

Urinary Incontinence

Treatment

Urodynamic testing with and without pudendal nerve stimulation

Clinical Study ID

NCT05900570
2023-117
  • Ages > 18
  • Female

Study Summary

The purpose of this early feasibility prospective study is to gain initial understanding of the effect of acute peri-urethral neurostimulation on the perineal nerves on intra-urethral pressure.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Female aged 18 years old or older

  • Capable of understanding the clinical study procedures and giving informed consent

  • Willing and able to undergo the study procedure

  • Diagnosis of SUI or stress predominant mixed incontinence, for at least 6 months

  • Provided authorization to use and disclose information for research purposes

Exclusion

Exclusion Criteria:

  • Predominant urge incontinence per patient report or medical record

  • Active symptomatic uncontrolled bladder instability as determined by theinvestigator

  • Regularly or intermittently used a urethral catheter

  • Active bladder cancer (currently undergoing or scheduled to undergo treatment forbladder cancer).

  • Previous radiation treatment in the pelvic floor

  • History or symptoms of cystocele, enterocele or rectocele of grade 3 or 4. Per themedical record or as determined by the investigator

  • Current infection (urethritis, cystitis or vaginitis) as determined by investigator.

  • Active herpes genitalis

  • Unevaluated hematuria

  • Currently taking, or has taken within 4 weeks prior to the screening/baseline visit,pharmacological treatment for SUI (including but not limited to, alpha adrenergics,and tricyclic antidepressants)

  • Severe or uncontrolled diabetes, (defined as being a diabetic with a hemoglobin A1cof ≥10%) per patient medical record.

  • History of drug/alcohol abuse, mental dysfunction, or other factors limiting herability to cooperate fully

  • Pregnancy test with positive result during screening or women who are breastfeeding

  • Women who are pregnant and/or have given birth in the previous 12 months

  • Have implanted active neurostimulators, pacemakers, or defibrillators;neurostimulators which are passive or that can be briefly turned off for thestimulation procedure are acceptable

  • Known systemic neurological dysfunctions

  • Severe coagulation disorders

  • Medically unstable at time of study and unsafe to undergo urodynamic testing (UDT)as determined by the investigator

  • Presence of an artificial urinary sphincter

  • Any medical condition (e.g. Multiple Sclerosis, spinal cord injury, mobility) oruncontrolled chronic disease (e.g. renal diseases that requires dialysis) that wouldinterfere with the patient's ability to comply with the protocol and/or may affectthe outcome of this study or safety of the subject as determined by the investigator

Study Design

Total Participants: 20
Treatment Group(s): 1
Primary Treatment: Urodynamic testing with and without pudendal nerve stimulation
Phase:
Study Start date:
February 26, 2024
Estimated Completion Date:
January 31, 2026

Study Description

In this study intra-urethral pressure data will be collected and analyzed with and without peri-urethral neurostimulation. This is a single arm feasibility study of women diagnosed with stress urinary incontinence. The data collected may help researchers have a better understanding of the effect, if any, on neurostimulation on stress or mixed urinary incontinence. After informed consent and all eligibility criteria are met, enrolled participants will be brought in for a stimulation visit. At the stimulation visit, participants will undergo urodynamic testing with and without stimulation. A prophylactic antibiotic will be given before the procedure and a local anesthetic cream will be applied topically to the peri-urethral area. The participant will be prepped for urodynamic testing per protocol. Commercially available simulation needles or leads and external neurostimulator device will be used to perform peri-urethral neurostimulation of the perineal branch of the pudendal nerve. The amplitude will gradually be increased and intra-urethral pressure will be recorded. Stimulation parameters such as amplitude, pulse-width, and frequency will be explored to assess their effect on urethral pressure. Amplitude progressively will be increased until discomfort is noted, no further pressure increases are observed, or maximum output is achieved. When a consistent pressure is observed, record intra-urethral pressure measurements with stimulation on and off. Next, Leak Point Pressure (LPP) testing with and without stimulation will be completed. Start the urodynamic saline infusion until desired volume is reached. Observe for urinary leakage. This will be repeated with the stimulation on.

Connect with a study center

  • Beaumont Hospital-Royal Oak

    Royal Oak, Michigan 48073
    United States

    Active - Recruiting

  • Corewell Health William Beaumont University Hospital

    Royal Oak, Michigan 48073
    United States

    Active - Recruiting

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