Urinary incontinence (UI) and lower urinary tract symptoms (LUTS) affect almost half of US women and cause substantial distress, diminished quality of life, and dramatic limitations in daily functioning. Obesity, a US and worldwide epidemic associated with enormous health and quality of life impact, is one of the strongest independent risk factors for UI and weight loss is an effective treatment for UI. However, the mechanisms by which obesity promotes UI and LUTS and why weight loss is an effective or UI in women are poorly understood. This proposal outlines a 5-year K24 Midcareer Investigator Award in Patient-Oriented Research (POR) renewal application for the candidate to expand her mentoring work with early career patient oriented researchers and promote a multidisciplinary, translational research paradigm focused on the association of weight and weight loss with UI and LUTS. In addition to mentoring plans, the proposal outlines specific aims to continue to advance our understanding of the association of UI, LUTS, and obesity in women by examining the effect of weight and weight loss on UI/LUTS in women, the possible roles of inflammation, physical activity, stress, and body habitus in the relationship between obesity and UI/LUTS, and facilitate the translational development of novel approaches to treatment and prevention of these conditions. The goals of this patient-oriented research and mentoring proposal will be achieved by efficiently leveraging existing resources, including ongoing NIH-funded clinical trials, comprehensive datasets, and productive research collaborations. The candidate's long-term goals are to be a leader in UI research, to contribute substantially to our understanding and approaches to the treatment and prevention of UI and LUTS, and to mentor the next generation of investigators interested in the epidemiology and treatment of female incontinence. Elucidating the mechanisms of the association between obesity with UI and LUTS in women will facilitate the translational development of novel approaches to treatment and prevention of these conditions. Strengths of the candidate include her formal training in research methods, history of research productivity and NIH funding, and a successful track record of mentoring junior trainees. Strengths of the institution include the resources of the UCSF CTSI and K30 Clinical Research Curriculum Award, several K12 training grants from which to recruit mentees, a unique formal mentor training program, and the availability of resources to foster research of junior POR investigators. The candidate has the enthusiastic support of her department, the UCSF CTSI, and patient-oriented research collaborators to pursue her research goals. The protected time provided by the K24 program is critical for the candidate to continue mentoring the next generation of investigators committed to patient-oriented research in the female lower urinary tract and advancing innovative research on the obesity-UI/LUTS associations.
Urinary incontinence (UI) and lower urinary tract symptoms (LUTS) affect almost half of US women and cause substantial distress, diminished quality of life, and dramatic limitations in daily functioning. Obesity is one of the strongest risk factors for UI. The proposed funding will support the expanded mentoring of early career investigators -- from every level of the training pipeline -- in patient-oriented research dedicated to improving outcomes women with UI and LUTS. It will also support multidisciplinary, translational patient-oriented research projects on the association of weight and weight loss with UI and LUTS. Elucidating the mechanisms of the association between obesity with UI and LUTS in women will facilitate the translational development of novel approaches to treatment and prevention of these conditions.
| Warsi, Qurratul A; Huang, Alison J; Hess, Rachel et al. (2018) Association of Pharmacologic Treatment of Urgency Urinary Incontinence With Sleep Quality and Daytime Sleepiness. Obstet Gynecol 131:204-211 |
| Winkelman, William D; Warsi, Ann; Huang, Alison J et al. (2018) Sleep Quality and Daytime Sleepiness Among Women With Urgency Predominant Urinary Incontinence. Female Pelvic Med Reconstr Surg 24:76-81 |
| Munaganuru, Nagambika; Van Den Eeden, Stephen K; Creasman, Jennifer et al. (2017) Urine leakage during sexual activity among ethnically diverse, community-dwelling middle-aged and older women. Am J Obstet Gynecol 217:439.e1-439.e8 |
| Suskind, Anne M; Cawthon, Peggy M; Nakagawa, Sanae et al. (2017) Urinary Incontinence in Older Women: The Role of Body Composition and Muscle Strength: From the Health, Aging, and Body Composition Study. J Am Geriatr Soc 65:42-50 |
| Huang, Alison J; Rowen, Tami S; Abercrombie, Priscilla et al. (2017) Development and Feasibility of a Group-Based Therapeutic Yoga Program for Women with Chronic Pelvic Pain. Pain Med 18:1864-1872 |
| Winkelman, William D; Huang, Alison J; Schembri, Michael et al. (2017) Modifiers of Response to Treatment With Fesoterodine for Urgency-Predominant Urinary Incontinence in a Randomized Controlled Trial. Female Pelvic Med Reconstr Surg 23:151-156 |
| Alfonso-Cristancho, Rafael; King, Wendy C; Mitchell, James E et al. (2016) Longitudinal Evaluation of Work Status and Productivity After Bariatric Surgery. JAMA 316:1595-1597 |
| Subak, Leslee L; King, Wendy C; Belle, Steven H et al. (2015) Urinary Incontinence Before and After Bariatric Surgery. JAMA Intern Med 175:1378-87 |
| Huang, Alison J; Jenny, Hillary E; Chesney, Margaret A et al. (2014) A group-based yoga therapy intervention for urinary incontinence in women: a pilot randomized trial. Female Pelvic Med Reconstr Surg 20:147-54 |
| Myers, Deborah L; Sung, Vivian W; Richter, Holly E et al. (2012) Prolapse symptoms in overweight and obese women before and after weight loss. Female Pelvic Med Reconstr Surg 18:55-9 |
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