Study to Determine Effects of Vesicare on Return to Continence Post - Radical Prostatectomy (Part II)

Study Overview
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Brief Summary
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Prostate cancer is the most common non-cutaneous malignancy in men and is the 2nd leading cause of death from cancer in men. Radical prostatectomy is one of the treatment options available for organ-confined disease. Over 100,000 radical prostatectomies cases (total removal of the cancerous prostate by surgery) are performed in the United States yearly. Unfortunately nearly all of the men undergoing surgery report diminished Quality of Life (QOL) scores due in part due to a postoperative incontinence which may require the use of multiple urinary pads per day. Many of these men also report debilitating irritative voiding symptoms of urinary urgency and frequency, and have overall decreased urinary satisfaction scores. Abatement of these symptoms can take up to one year in men, and in 5-20% of patients symptoms may persist for longer periods. Our recent published findings suggest that instability in the bladder muscle is likely an underlying etiology in postoperative urinary incontinence. This 'Detrusor Muscle' instability results in excess contractions of the urinary bladder ('urgency to urinate'), and can result in the feeling of needing to urinate more frequently. Consistent with this hypothesis of detrusor muscle instability, men with postoperative dribbling had more complaints with urgency, frequency and bother scores when queried with validated questionnaires. We suspect that a transient bladder muscle contraction may overcome the urinary sphincter valve resistance and result in the patient's dribbling of urine. By treating the bladder muscle instability, we expect improved postoperative continence and improved quality of life in patients after undergoing surgery for total removal of a cancerous prostate. This pilot study will assess the statistical requirements for the number of subjects needed for a fully 'powered' randomized prospective study to fully evaluate whether medications such as solifenacin significantly improve patients' quality of urinary life and improve postoperative urinary incontinence after surgery. *This study has been modified from the original protocol with the clinicaltrials.gov ID: NCT00581061.

Official Title
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Vesicare™ (Solifenacin) in the Treatment of Urinary Incontinence After Radical Prostatectomy

Conditions
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Urinary Incontinence

Intervention / Treatment
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* Drug: Vesicare


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients that have been diagnosed with prostate cancer and will undergo treatment for the disease as part of standard clinical care Patients that have multiple pad use a few days after standard of care catheter removal Exclusion Criteria: Contra-indication to Solifenacin Narrow angle glaucoma Hepatic impairment Renal impairment CYP3A4 inhibitors (e.g. Ketoconazole) Gastric Retention (delayed or slow emptying of the stomach) Lives in a different country

Ages Eligible for Study
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Minimum Age: 18 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: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Vesicare<br>Vesicare 5mg daily for 90 days was prescribed for men presenting with post-Robotic Assisted Radical Prostatectomy (RARP) severe incontinence. | Drug: Vesicare<br>* 5 mg daily<br>* Other names: Vesicare (Solifenacin);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Continence | Days to zero pad continence were assessed by patient self-reported Pad free continence declaration card. | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Incontinence, Robotic Prostatectomy, Prostate Cancer