This proposal addresses one of the most important issues concerning women's health. Urinary Incontinence affects 40% of adult women in the US while stress urinary incontinence (SUI) accounts for a large portion of the affected patients. Over 165,000 surgical procedures are performed for SUI in the U.S. Among the various treatment options, sling procedure has become the mainstay of surgical treatment in the management of SUI. While sling procedure offers the highest success rate, it also results in the highest rate of morbidity and complication among all anti-incontinence procedures (as high as 68%). These complications include voiding dysfunction, urinary retention and possibly worsening of continence mechanism. In a search for an animal model in which the various research questions related to the sling procedure could be tested in a laboratory setting, we have developed, validated and published (Hijaz et al. J of Urol. Nov. 2004) a new rat model of vaginal sling procedure. Using this model and based on our preliminary data, we hypothesize that sling procedure and its associated vaginal dissection causes bladder dysfunction, and damages the urethral sphincter function in the female rat model of SUI. We plan to test this hypothesis in one specific aim. In SA#1, we will examine the effects of sling procedure and its associated vaginal dissection on the bladder function and the LUT continence mechanisms in female rat model of SUI at 6 weeks. Using a total of 125 animals, the effects of sling and vaginal dissection on cystometrogram, contractility, LPP, and morphometry of the urethral sphincter will be examined in five animal groups. According to their assignment, animals in each group (n=25) will undergo pudendal nerve transaction (PNT), PNT+ sling, PNT+ sham sling (vaginal dissection), vaginal dissection alone or no procedure. The long-term goal of this proposal is to expand the findings of this project into an R01 application in order to translate our findings into relevant clinical studies. ? ?
