Evaluating the Efficacy and Patient Experience of Catheter-Free Intravesical Instillation (NOCATIN)

Jahn Ferenc South Pest Teaching Hospital

Status: Enrolling

Conditions: Bladder Cancer; Interstitial Cystitis; Intravesical Instillation; Haemorrhagic Cystitis; Bladder Pain Syndrome; Recurrent Urinary Tract Infections; Recurrent Cystitis; Bladder Disease

Treatments: Device: Catheter-Free Intravesical Instillation with a special syringe adapter

Study type: Observational

Funder types: Other

Identifiers

NCT06719232

NOCATIN

Details and patient eligibility

About

This study aims to evaluate a catheter-free method for delivering medications directly into the bladder, known as intravesical instillation, which is commonly used to treat conditions such as interstitial cystitis/bladder pain syndrome (IC/BPS), recurrent urinary tract infections, bladder cancer, and post-chemotherapy or post-radiation cystitis.

The study investigates whether this method, which eliminates the need for catheterization, reduces discomfort and complications while maintaining treatment effectiveness. By collecting data on patient experiences and outcomes, the study seeks to determine if this approach provides a safer and more comfortable alternative to traditional catheter-based treatments.

Full description

Intravesical instillation, a method involving the direct administration of therapeutic agents into the bladder via a catheter, is widely used in the treatment of various urological conditions, including interstitial cystitis/bladder pain syndrome (IC/BPS), recurrent urinary tract infections (UTIs), post-chemotherapy and post-radiation cystitis, and non-muscle invasive bladder cancer. This approach allows high concentrations of medication to be delivered directly to the bladder without systemic exposure, thereby enhancing treatment efficacy while reducing the risk of systemic side effects.

A notable drawback of traditional intravesical treatments is the need for catheterization. However, catheter-free intravesical instillations have become possible with the use of a specialized urological adapter that requires only 6-8 mm insertion into the urethral opening (UroDapter). By relaxing the urethral sphincter, patients can facilitate the delivery of the instillation fluid into the bladder without a catheter. This method is painless, causes minimal discomfort, and significantly reduces the risk of urinary tract infections, urethral bleeding, and urethral strictures compared to catheter-based approaches. Catheter-free intravesical instillations have been performed in Hungarian outpatient urology settings since 2018.

This prospective observational study includes patients whose physicians recommended catheter-free bladder instillation therapy. The study aims to anonymously collect data on the treatment's effectiveness, patient experience and incidence of complications associated with the caheter-free approach, focusing on its application for IC/BPS, recurrent UTIs, post-chemotherapy and post-radiation cystitis, and bladder cancer. Findings will be instrumental in refining protocols for intravesical treatments and enhancing patient compliance and satisfaction.

Enrollment: 300 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male and female patients aged between 18 and 80 years.
• Patients for whom the treating physician has determined that intravesical instillation is necessary due to one of the following conditions:
• Interstitial cystitis/bladder pain syndrome (IC/BPS).
• Recurrent urinary tract infections (UTIs).
• Non-muscle invasive bladder cancer.
• Post-radiation cystitis.
• Post-chemotherapy cystitis.
• Negative urine culture within the last two weeks.
• Patients who provide verbal and written informed consent to participate in the study.

Exclusion criteria

• Urinary tract infection within the past month or currently active infection.
• Diagnosed bleeding disorders or recurrent macroscopic hematuria.
• Post-void residual urine volume greater than 100 ml.
• Mental condition that prevents reliable cooperation.

Trial design

300 participants in 1 patient group

Catheter-Free Intravesical Instillation Patients

Description:

This group consists of patients receiving catheter-free intravesical instillation treatments with a special syringe adapter, called UroDapter for any conditions, including interstitial cystitis/bladder pain syndrome (IC/BPS), recurrent urinary tract infections (UTIs), post-chemotherapy cystitis, post-radiation cystitis, and non-muscle invasive bladder cancer.

Treatment:

Device: Catheter-Free Intravesical Instillation with a special syringe adapter