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A Randomised Controlled Trial to Assess the Effectiveness and Cost Effectiveness of TURP, Laser and Watchful Waiting in the Treatment of Bladder Outflow Obstruction
Source of recordUK Clinical Trials Gateway
ISRCTNISRCTN16113281
Date ISRCTN assigned23/01/2004
Local reference number(s)941003 r245/02340
Public titleA Randomised Controlled Trial to Assess the Effectiveness and Cost Effectiveness of TURP, Laser and Watchful Waiting in the Treatment of Bladder Outflow Obstruction
Scientific title
AcronymThe CLasP Study
Disease/condition/study domainUrological and genital diseases: Other urological and genital disease
Study hypothesisTen to fifteen percent of men aged 40 undergo transurethral prostatectomy (TURP) in their lifetime.
About 20% do not achieve satisfactory symptomatic results, 5% to 10% suffer major morbidity and 0.2% to 1% die from the procedure. The annual cost of TURP in the USA is in excess of $3,000,000,000. New, less invasive treatments are now available including laser treatment which may be provided as a day-case procedure. It is unclear how laser treatment compares with TURP or indeed with conservative treatment (watchful waiting - reassurance and advice) in terms of cost, effectiveness, improvement in quality of life and urodynamic outcome. These deficiencies in knowledge are clearly very important to the NHS which cannot afford to take up high cost, high technology treatments unless they are shown to be of clear benefit. We propose carrying out a randomised controlled trial comparing TURP, laser treatment and watchful waiting in men who would normally undergo TURP.
Design/methodologyRandomised controlled trial
Research ethics reviewNot provided at time of registration
Countries of trialUnited Kingdom
Participants - inclusion criteriaMen with uncomplicated lower urinary tract symptom that is not acute or chronic urinary retention.
Participants - exclusion criteriaNot provided at time of registration
Patient information material
Anticipated start date10/01/1994
Anticipated end date30/09/1997
Status of trialCompleted
Target number of participantsNot provided at time of registration
Interventionsi. Laser therapy with a noncontact, side firing neodymium:YAG probe
ii. TURP (standard transurethral prostatic resection)
iii. Watchful waiting (conservative management, including monitoring without active intervention)
Primary outcome measure(s)Primary outcomes were International Prostate Symptom Score (I-PSS), maximum urinary flow rate, a composite measure of success based on I-PSS and maximum urinary flow rate categories, I-PSS quality of life score and post-void residual urine volume.
Secondary outcome measure(s)Secondary outcomes included treatment failure, hospital stay and major complications.
Sources of fundingNHS Executive Northern and Yorkshire
Sponsor nameNHS R&D Regional Programme Register - Department of Health (UK)
Sponsor detailsThe Department of Health
Richmond House
79 Whitehall
London
United Kingdom
SW1A 2NL
Sponsor telephone+44 (0)20 7307 2622
Sponsor fax+44 (0)20 7307 2623
Sponsor emaildhmail@doh.gsi.org.uk
Sponsor websitehttp://www.doh.gov.uk
Contact nameProf David Neal
Contact detailsUniversity of Newcastle
Department of Surgery
Framlington Place
Newcastle upon Tyne
United Kingdom
NE2 4HH
Contact telephone+44 0191 222 7067/232 5131 ext 24719
Contact fax+44 0191 222 8514
Contact emaild.e.neal@ncl.ac.uk
More informationFor more up-to-date information please go to the ISRCTN link below.
Link to record in ISRCTN RegisterISRCTN16113281
Date last extracted from ISRCTN register17/04/2008
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