Transpelvic Magnetic Stimulation to Improve Urogenital Function

Study Overview
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Brief Summary
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After recruitment, 20 male patients will be assigned 1:1 to either age-matched control (G1: sham) or age-matched intervention (G2: pelvic magnetic stimulation; TPMS) groups using computer-generated process, and baseline parameters will be established. All patients will be instructed by the investigators to perform standard of care pelvic floor exercise for the duration of the study. In addition, G2 patients will receive TPMS, while G1 patients will undergo sham treatment.

Detailed Description
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The investigators will use a custom TPMS device that targets pelvic muscles. The investigators will apply low amplitude (5%) TPMS to improve blood flow, then high amplitude (30-50%) to strengthen pelvic muscles. The treatment regimen will involve two 20-minute sessions/visit and 2 -visits per week for 12-weeks (final monitoring at 24 weeks). TPMS will be administered by a trained clinical coordinator under the supervision of a urologist. Symptom scores and hemodynamic changes will be evaluated monthly. MRI for assessing muscle thickness will be performed in the beginning (before TPMS) and at the end (after TPMS) of the study. The investigators will assess functional improvements using symptom scores. Morphological changes will be determined by MRI.

Official Title
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Feasibility Testing of Transpelvic Magnetic Stimulation as a Novel Intervention toImprove Urogenital Function in Prostate Cancer Survivors

Conditions
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Prostate Cancer, Erectile Dysfunction

Intervention / Treatment
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* Procedure: Sham Magnetic stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: men over 50 years old who are enrolled for prostate surgery, have serum testosterone within normal limits, and are without prior bilateral orchiectomy, chemotherapy, external radiotherapy, brachytherapy, surgical, or other ablative therapy for prostate cancer. Exclusion Criteria: patients with ED caused by psychological, neurogenic (after non-nerve sparing prostate surgery), or hormonal disorders, patients with genital abnormalities precluding intercourse, prior penile implantation, ongoing erectile aid use, or use of nitrate medications. Androgen suppression within the past 6 months or as part of protocol-specified radiotherapy or brachytherapy will be excluded.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Intervention to prevent prostate cancer surgery related urological issues
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Magnetic Stimulation<br>Patients will be subjected to TPMS. | Procedure: Sham Magnetic stimulation<br>* Sham Magnetic stimulation for comparison.<br>|
| No Intervention: Sham TPMS<br>Patients will be subjected to sham TPMS | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvements in sexual function change | Primary outcome measure will be to determine improvements in male sexual (erectile) function after magnetic stimulation therapy. The objective measure for erectile function will be the International Index of Erectile Function (IIEF), a validated, 5-item symptom-subjective score. These five items focus on male erectile function. Response options are based on rating scales from 1 to 5 and the responses are added to form a total IIEF-5 score from 5 to 25. Lower scores indicate poor sexual function and higher scores after therapy will indicate improvement. | At baseline and at 4, 8, 12, 13 and 24 weeks 24-weeks post therapy | 
| Change in number of pads used as a measure of Improvements in continence function | The first objective measure for urinary incontinence (UI) change will be the number of pads used in 24-hours as an index of urine leakage. Higher number of pad use will indicate severe UI and lower number pad use after therapy will indicate improvement. | At baseline and at 4, 8, 12, 13 and 24 weeks 24-weeks post therapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvements in penile blood flow change | Penile blood flow will be measured as peak systolic velocity (mm/sec) using laser Doppler method. | Penile blood flow (mm/sec) will be measured at baseline and at 4, 8, 12, 13 and 24 weeks post- treatment. | 
| Improvements in pelvic muscle thickness change | Muscle thickness (mm) will be measured by anatomical MRI and quantified using imaging software such as Amira. | Muscle thickness (mm) will be measured at baseline and at 13 weeks post- treatment. | 
| Change in Pad weight as a measure of Improvements in continence function | The second objective measure for urinary incontinence (UI) change will be the total weight of the pads used in 24-hours as an index of urine leakage. Higher number of pad weight will indicate severe UI and lower number pad use after therapy will indicate improvement. | At baseline and at 4, 8, 12, 13 and 24 weeks 24-weeks post therapy | 
| Change in urinary symptom score as a measure of Improvements in continence function | The third objective measure for urinary incontinence (UI) change will be the change in urinary symptom scores. The investigators will use International Consultation of Incontinence Questionnaire (ICIQ)-symptom score (scores range: 0-21), a score which assesses the symptoms and effect of UI on quality of life. Higher scores will indicate severe UI and lower scores after therapy will indicate improvement. | At baseline and at 4, 8, 12, 13 and 24 weeks 24-weeks post therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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urinary incontinence, hemodynamics