Pelvic Floor Muscle Training in Treating Urinary Incontinence in Gynecologic Cancer Survivors

Sponsor
New Mexico Cancer Care Alliance (Other)
Overall Status
Completed
CT.gov ID
NCT01806350
Collaborator
National Cancer Institute (NCI) (NIH)
40
1
2
34
1.2

Study Details

Study Description

Brief Summary

This randomized pilot clinical trial studies pelvic floor muscle training in treating urinary incontinence in gynecologic cancer survivors. Pelvic floor muscle training may help control symptoms and improve physical function and quality of life in gynecologic cancer survivors.

Condition or Disease Intervention/Treatment Phase
  • Other: questionnaire administration
  • Procedure: standard follow-up care
  • Other: educational intervention
N/A

Detailed Description

PRIMARY OBJECTIVES:
  1. To assess whether pelvic floor muscle training and behavioral therapy in gynecologic cancer survivors results in improvement in incontinence symptoms as measured by a validated questionnaire (Patient Global Impression of Improvement) at three month follow-up when compared to women who do not undergo pelvic floor muscle training.

  2. To evaluate whether women who undergo pelvic floor muscle training and behavioral therapy report greater improvement in validated urinary incontinence symptom severity, pelvic floor distress and quality of life measures than women who do not undergo pelvic floor muscle training.

  3. To evaluate the acceptability of pelvic floor muscle training (PFMT) among gynecological cancer survivors and to provide preliminary data to inform a power analysis for a larger randomized trial.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive a handout describing behavioral management tips for urinary incontinence, including information and suggestions about optimal volume fluid intake, constipation management, measures to reduce urgency by spreading fluid intake, and avoiding caffeine and other bladder irritants that have proved effective in other intervention trials. Patients undergo PFMT over 20-30 minutes teaching them to contract the pelvic floor muscles correctly and receive feedback to avoid the contraction of abdominal, gluteal or adductor muscles. Patients are asked to perform 3 sets of 10 pelvic muscle contractions with a goal of holding the contraction for 5 seconds daily for 12 weeks and also receive a reminder phone call to address concerns and review the instructions at 4 weeks.

ARM II: Patients receive usual care for urinary incontinence, with an option to join the training program after completion of study.

After completion of study treatment, patients are followed up at 3 months.

Study Design

Study Type:
Interventional
Actual Enrollment :
40 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Supportive Care
Official Title:
A Pilot Randomized Control Trial to Evaluate Pelvic Floor Muscle Training for Urinary Incontinence Among Gynecologic Cancer Survivors
Study Start Date :
Nov 1, 2009
Actual Primary Completion Date :
Sep 1, 2012
Actual Study Completion Date :
Sep 1, 2012

Arms and Interventions

Arm Intervention/Treatment
Experimental: Arm I (PFMT)

Patients receive a handout describing behavioral management tips for urinary incontinence, including information and suggestions about optimal volume fluid intake, constipation management, measures to reduce urgency by spreading fluid intake, and avoiding caffeine and other bladder irritants that have proved effective in other intervention trials. Patients undergo PFMT over 20-30 minutes teaching them to contract the pelvic floor muscles correctly and receive feedback to avoid the contraction of abdominal, gluteal or adductor muscles. Patients are asked to perform 3 sets of 10 pelvic muscle contractions with a goal of holding the contraction for 5 seconds daily for 12 weeks and also receive a reminder phone call to address concerns and review the instructions at 4 weeks.

Other: questionnaire administration
Ancillary studies

Other: educational intervention
Undergo PFMT
Other Names:
  • intervention, educational
  • Active Comparator: Arm II (usual care)

    Patients receive usual care for urinary incontinence, with an option to join the training program after completion of study.

    Other: questionnaire administration
    Ancillary studies

    Procedure: standard follow-up care
    Receive usual care

    Outcome Measures

    Primary Outcome Measures

    1. Improvement in the Patient Global Impression of Improvement (PGI-I) rating [12 weeks]

      Fisher's exact test will be used to test whether the chance of success is identical for the two groups (intervention vs. control).

    Secondary Outcome Measures

    1. Changes in the Incontinence Severity Index (ISI) score [Baseline to 3 months]

      The Brinks scale will be used by the trainers for the treatment group follow-up to evaluate the adequacy of the contractions in a qualitative manner. A two sample t-test on the within individual differences will be used. A non-parametric Mann-Whitney test will be used if the sample differences are non-normally distributed.

    2. Changes in Urinary Distress Inventory (UDI) [Baseline to 3 months]

      The Brinks scale will be used by the trainers for the treatment group follow-up to evaluate the adequacy of the contractions in a qualitative manner. A two sample t-test on the within individual differences will be used. A non-parametric Mann-Whitney test will be used if the sample differences are non-normally distributed.

    3. Changes in Incontinence Impact Questionnaire (IIQ), which measures the impact of urinary incontinence on quality of life [Baseline to 3 months]

      The Brinks scale will be used by the trainers for the treatment group follow-up to evaluate the adequacy of the contractions in a qualitative manner. A two sample t-test on the within individual differences will be used. A non-parametric Mann-Whitney test will be used if the sample differences are non-normally distributed.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    30 Years and Older
    Sexes Eligible for Study:
    Female
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • History of uterine, cervical, ovarian or vulvar malignancy

    • Treatment free interval of >= one year and currently have no evidence of cancer

    • Reports urinary incontinence based on screening questionnaire

    • Must have a stable address for the three month period

    Exclusion Criteria:
    • Current clinical evidence of urinary tract infection

    • Within three months of failed surgery for urinary incontinence

    • Planned surgery for urinary incontinence in the next three months

    • Presence of neurologic condition that may impact bladder symptoms such as multiple sclerosis, stroke

    • Pregnancy

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of New Mexico Cancer Center Albuquerque New Mexico United States 87106

    Sponsors and Collaborators

    • New Mexico Cancer Care Alliance
    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Teresa Rutledge, MD, University of New Mexico Cancer Center

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    New Mexico Cancer Care Alliance
    ClinicalTrials.gov Identifier:
    NCT01806350
    Other Study ID Numbers:
    • INST 0912
    • NCI-2012-01319
    First Posted:
    Mar 7, 2013
    Last Update Posted:
    Mar 7, 2013
    Last Verified:
    Mar 1, 2013

    Study Results

    No Results Posted as of Mar 7, 2013