This proposal seeks to improve care for the women who suffer the priority health conditions of urinary incontinence and pelvic organ prolapse. These problems arise due to women's unique role in giving birth and, therefore, occur much less often in men. Each year 3 million women deliver babies and 11 % of women need surgery for incontinence and prolapse. A lack of basic understanding of the mechanisms involved in these conditions and their implications for treatment impedes progress. We propose a SCOR to unite 5 existing multidisciplinary researchers and to add 4 new investigators to expedite development of new knowledge needed to improve treatment and prevention. Project 1, """"""""Biomechanics"""""""" will test hypotheses concerning basic mechanisms of pelvic floor structure and function. It will analyze the mechanical arrangement and properties of the components of the pelvic floor as well as how vaginal birth damages their integrity. Project 2, """"""""Clinical Mechanisms"""""""" will test continent and stress incontinent women to detect the unique failure of component parts that, singularly and in combinations, are associated with stress incontinence. Project 3, """"""""Treatment Selection"""""""" will identify the effects of birth induced muscle damage in women with stress incontinence and from these data, build and test a model to determine which defects will predict success or failure of pelvic muscle treatment. Core A, Administrative/Human Subjects/Biostatistics core provides project support by recruiting subjects, compiling and analyzing data and protecting subject safety. In Core A, two study groups will be formed concerning 1) Gender Impact and 2) Basic Sciences Futures to discuss expanding the issues raised by this research. Core B, Measurement & Imaging will provide technical support for the projects along with integrated image analysis for 2 and 3 dimensional spatial data gathered across projects. This research will produce needed insights to help women with pelvic floor dysfunction.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Specialized Center (P50)
Project #
5P50HD044406-05
Application #
7114904
Study Section
Special Emphasis Panel (ZAR1-AAA-C (O2))
Program Officer
Parrott, Estella C
Project Start
2002-09-25
Project End
2007-07-31
Budget Start
2006-08-01
Budget End
2007-07-31
Support Year
5
Fiscal Year
2006
Total Cost
$1,194,135
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
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Huebner, Markus; DeLancey, John O L; Reisenauer, Christl et al. (2018) Magnetic resonance imaging of vaginal support structure before and after Vecchietti procedure in women with Mayer-Rokitansky-Küster-Hauser syndrome. Acta Obstet Gynecol Scand 97:830-837
Masteling, Mariana; Ashton-Miller, James A; DeLancey, John O L (2018) Technique development and measurement of cross-sectional area of the pubovisceral muscle on MRI scans of living women. Int Urogynecol J :
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Tracy, Paige V; Wineman, Alan S; Orejuela, Francisco J et al. (2018) A constitutive model description of the in vivo material properties of lower birth canal tissue during the first stage of labor. J Mech Behav Biomed Mater 79:213-218
Sammarco, Anne G; Nandikanti, Lahari; Kobernik, Emily K et al. (2017) Interactions among pelvic organ protrusion, levator ani descent, and hiatal enlargement in women with and without prolapse. Am J Obstet Gynecol 217:614.e1-614.e7
Harris, John A; Sammarco, Anne G; Swenson, Carolyn W et al. (2017) Are perioperative bundles associated with reduced postoperative morbidity in women undergoing benign hysterectomy? Retrospective cohort analysis of 16,286 cases in Michigan. Am J Obstet Gynecol 216:502.e1-502.e11
DeLancey, John O L (2017) ""Mommy, how will the baby get out of your tummy? Will it hurt you?"" Am J Obstet Gynecol 217:110-111

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