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Trial registered on ANZCTR
Registration number
ACTRN12618000587202
Ethics application status
Approved
Date submitted
5/04/2018
Date registered
17/04/2018
Date last updated
17/04/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessment of pelvic floor injury following childbirth in women with genital tract fistula and prolapse
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Scientific title
Assessment of pelvic floor injury following childbirth in women with genital tract fistula and prolapse
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Secondary ID [1]
294510
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obstetric fistula
307283
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pelvic organ prolapse
307284
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Condition category
Condition code
Reproductive Health and Childbirth
306400
306400
0
0
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Other reproductive health and childbirth disorders
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Renal and Urogenital
306451
306451
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Women presenting to Kagando hospital, Uganda with obstetric fistula and pelvic organ prolapse - routine history and clinical examination of presenting complaint, routine assessment of women with trans-perineal 4D pelvic floor ultrasound scan.
Each patients undergoes a single episode of assessment which includes history taking and ultrasound assessment - duration approximately 1 hour total for each patient.
The total clinical study period extends from 10/4/2011 - 15/7/2012.
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Intervention code [1]
300811
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The number of patients with levator muscle defects in each patient group (obstetric fistula, pelvic organ prolapse) will be assessed.
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Assessment method [1]
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Timepoint [1]
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The ultrasound is performed immediately following initial assessment with history and clinical examination
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Primary outcome [2]
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The number of patients with enlarged levator hiatal areas in each patient group (obstetric fistula, pelvic organ prolapse) will be assessed.
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Assessment method [2]
305516
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Timepoint [2]
305516
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The ultrasound is performed immediately following initial assessment with history and clinical examination.
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Secondary outcome [1]
345113
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The mode of delivery for each participant will be determined by history taking.
This will subsequently be compared to ultrasound outcome measures which will include levator muscle defects and levator hiatal areas..
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Assessment method [1]
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Timepoint [1]
345113
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The history is obtained as soon as the woman arrives at the hospital, and the ultrasound scan soon after.
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Eligibility
Key inclusion criteria
All women attending surgical camps at Kagando hospital in 2011 and 2012 were invited to participate - the women presenting were diagnosed with obstetric fistula and pelvic organ prolapse.
All women had previously had a pregnancy resulting in obstetric fistula (with the youngest participant aged 15) or had subsequently developed pelvic organ prolapse.
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Minimum age
15
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women who did not consent
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
No sample size calculations were undertaken.
Ultrasound scan features including presence of levator muscle defects and elevator hiatal area was measured and statically compared to check for any differences between the obstetric fistula group (bladder of bowel) and pelvic organ prolapse.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
10/04/2011
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Date of last participant enrolment
Anticipated
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Actual
15/07/2012
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Date of last data collection
Anticipated
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Actual
15/07/2012
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Sample size
Target
82
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Accrual to date
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Final
82
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Recruitment outside Australia
Country [1]
10257
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Uganda
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State/province [1]
10257
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Funding & Sponsors
Funding source category [1]
299136
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Self funded/Unfunded
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Name [1]
299136
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Dr Hannah Krause. No funding obtained.
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Address [1]
299136
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Suite 209
Ramsay Specialist Centre, Greenslopes Private hospital,
Newdegate Street, Greenslopes, 4120
Queensland, Australia
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Country [1]
299136
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Australia
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Primary sponsor type
Individual
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Name
Dr Hannah Krause
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Address
Suite 209
Ramsay Specialist Centre, Greenslopes Private hospital
Newdegate Street, Greenslopes 4120
Queensland, Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
298395
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nil
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Address [1]
298395
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nil
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Country [1]
298395
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
300067
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Greenslopes Research and Ethics Committee
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Ethics committee address [1]
300067
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Greenslopes Private hospital Newdegate Street, Greenslopes, 4120 Queensland, Australia
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Ethics committee country [1]
300067
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Australia
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Date submitted for ethics approval [1]
300067
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25/02/2011
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Approval date [1]
300067
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07/04/2011
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Ethics approval number [1]
300067
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Protocol 11/09
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Summary
Brief summary
Pelvic floor injury following childbirth is common. In recent years, 4D ultrasound scanning of the pelvic floor has identified injuries within the pelvis not visible on clinical examination. Trauma of the pelvic floor muscles (levator muscles), where these muscles are torn (avulsed) from their insertions to the pelvic bone, can be identified with pelvic floor ultrasound scanning. Levator muscle avulsion may be responsible for the development of pelvic organ prolapse in women. Prolonged neglected obstructed labour (childbirth) is the most common cause of obstetric fistula worldwide. Obstetric fistula refers to a hole between the urinary tract and the vagina, or the bowel and the vagina. This results in the constant leakage of urine or faeces into the vagina. Obstetric fistula and pelvic organ prolapse are common pelvic organ injuries in women following childbirth in Uganda. Pelvic floor ultrasound assessment of these women to assess for levator muscle avulsion and other anatomical features including levator hiatal areas, will identify any correlation between these injuries and whether the patient suffered an obstructed labour with development of fistula. The women with obstetric fistula and pelvic organ prolapse will be assessed and offered surgery as required. The assessment includes: 1. Assessment of pelvic organ prolapse patients undergoing surgery – routine clinical examination, routine history including standardised questionnaire, 4D ultrasound scan examination. 2. Assessment of obstetric fistula patients undergoing surgery – routine clinical examination, routine history including standardised questionnaire, 4D ultrasound scan examination. Pelvic floor muscle avulsion (levator avulsion) has been identified in developed countries with 4D ultrasound scanning in 20% of women following their first delivery. There is no data available regarding these injuries from deliveries in developing countries. There is minimal data available on the incidence of prolapse in developing countries. The study will take place at Kagando hospital, Uganda, where the investigators have been invited as experts to perform surgery on patients with obstetric fistula and pelvic organ prolapse.
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Trial website
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Trial related presentations / publications
None
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Public notes
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Contacts
Principal investigator
Name
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Dr Hannah Krause
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Address
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Suite 209, Ramsay Specialist Centre
Greenslopes Private hospital, Newdegate Street,
Greenslopes, Queensland
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Country
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Australia
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Phone
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+61 7 38478998
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Fax
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+61 7 38476433
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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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Hannah Krause
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Address
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Suite 209, Ramsay Specialist Centre
Greenslopes Private hospital, Newdegate Street,
Greenslopes, Queensland
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Country
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Australia
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Phone
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+61 7 38478998
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Fax
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+61 7 38476433
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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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Hannah Krause
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Address
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Suite 209, Ramsay Specialist Centre
Greenslopes Private hospital, Newdegate Street,
Greenslopes, Queensland
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Country
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Australia
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Phone
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+61 7 38478998
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Fax
82456
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+61 7 38476433
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Email
82456
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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
No additional documents have been identified.
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