The LURN Research Network was formulated in order to: 1) develop and test symptom-based measurement tools (patient-reported outcomes) to quantify and measure the entire spectrum of lower urinary tract disorders (LUTD) in men and women, 2) conduct in-depth phenotyping of targeted LUTD subpopulations, 3) identify methods or biomarkers which correlate with clinical symptom initiation or progression, and 4) distribute findings to the research community. This proposal from a team of experienced clinicians and researchers at the University of Michigan demonstrates our ability to recruit men and women with a broad range of LUTD. A series of innovative phenotyping studies are then proposed in order to help the LURN address its stated goals. Our group is committed to working collaboratively with the LURN network to recruit patients into existing protocols or to help in the development of new studies related to symptom measurement and phenotyping.
Specific Aim 1 is to successfully recruit patients into the LURN network. The recruitment team includes Urologists (n=5), Urogynecologists (n=4), Family Medicine physicians (n=3), and Physician Assistants (n=2). This group has well established and ongoing clinical and research collaborations, and has demonstrated the ability to recruit a broad range of male and female LUTD patients for research studies, including urinary incontinence, voiding dysfunction, and pelvic pain.
Specific Aim 2 is to conduct innovative phenotyping studies in subgroups of LUTD patients. We describe three phenotyping projects which assess different potential etiologic mechanisms for LUTD. Project 1 correlates measures of global (non-urologic) sensory sensitivity with LUTD symptoms. We hypothesize that global sensory abnormalities will be less common in LUTD patients than in pelvic pain patients recruited through the NIDDK MAPP research network. Project 2 will measure the degree of lower urinary tract fibrosis utilizing novel urine markers. We hypothesize that the degree of fibrosis will correlate with LUTD symptom severity in men and women. Project 3 will assess urethral function using urethral pressure profilometry in women with urge urinary incontinence and asymptomatic controls. We hypothesize that women with urge incontinence symptoms will have poor urethral urethral function compared with asymptomatic controls. These three phenotyping projects are designed to identify clinically relevant subgroups of LUTD patient who may benefit from unique, targeted therapies.
We describe our experience in enrolling patients with urinary symptoms into research studies. We then describe some new studies that could help us identify important differences between these patients so that we can develop more effective treatments for individual patients.