This proposal seeks to improve care for the women who suffer the priority health conditions of pelvic floor dysfunction;problems that arise due to women's unique role in giving birth. It addresses the sex disparities that exist in these problems. Each year 3 million women deliver babies and 300,000 women need surgery for pelvic floor dysfunction. A lack of basic understanding of the mechanisms of birth-related injury and recovery during reproductive years and mechanisms of prolapse later in life block efforts to prevent damage, improve recovery, or improve treatment. We seek continued support for a broadly interdisciplinary group of researchers from 4 schools and 2 institutes to that has expedited development of new knowledge needed to improve treatment and prevention. Project 1: """"""""Birth Biomechanics"""""""" will test hypotheses concerning basic mechanisms of pelvic floor injury during vaginal birth;the single largest factor in causing pelvic floor dysfunction to identify specific situations may increase or decrease injury risk. Project 2: """"""""Injury Recovery"""""""" will identify risk factors associated with levator injury, test the hypothesis that these injuries are, in fact, related to vaginal delivery and determine early predictors of eventual recovery. Project 3, """"""""Mechanisms of Posterior Vaginal Prolapse"""""""" will use advanced imaging and deformation analysis to test hypotheses concerning the basic disease mechanisms responsible for posterior vaginal wall prolapse, one of the most common and strongly birth-associated pelvic floor dysfunction. 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 Science Futures to discuss expanding the issues raised by this research. Core B: Measurement and Imaging core will provide technical support for the projects along with integrated analysis for 2 and 3 dimensional spatial data gathered across projects. This research will produce insights to address the women's health problem of 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 #
5P50HD044406-10
Application #
8134476
Study Section
Special Emphasis Panel (ZRG1-HOP-U (40))
Program Officer
Parrott, Estella C
Project Start
2002-09-25
Project End
2012-09-19
Budget Start
2011-09-01
Budget End
2012-09-19
Support Year
10
Fiscal Year
2011
Total Cost
$1,092,680
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
Swenson, Carolyn W; Morgan, Daniel M; George, Jenny et al. (2018) Effect of Cystocele Repair on Cervix Location in Women With Uterus In Situ. Female Pelvic Med Reconstr Surg 24:56-59
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-K├╝ster-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 :
Tracy, Paige V; Wadhwani, Shreya; Triebwasser, Jourdan et al. (2018) On the variation in maternal birth canal in vivo viscoelastic properties and their effect on the predicted length of active second stage and levator ani tears. J Biomech 74:64-71
Sammarco, Anne G; Swenson, Carolyn W; Kamdar, Neil S et al. (2018) Rate of Pelvic Organ Prolapse Surgery Among Privately Insured Women in the United States, 2010-2013. Obstet Gynecol 131:484-492
Berger, Mitchell B; Kolenic, Giselle E; Fenner, Dee E et al. (2018) Structural, functional, and symptomatic differences between women with rectocele versus cystocele and normal support. Am J Obstet Gynecol 218:510.e1-510.e8
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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