The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) was assembled in 2012 to increase our understanding of lower urinary tract symptoms (LUTS) by identifying important subtypes of patients with LUTS, and improving the measurement of patient experiences of LUTS. The Network's approach to defining patient subtypes was based on a re-sampling-based consensus clustering approach using self- reported patient data, resulting in the identification of novel LUTS-based clusters that are statistically and clinically distinct. The approach to improving the measurement of patient reports of LUTS was to systematically develop a new, high-quality item bank based on qualitative input from patient, community participants, internists, urologists, urogynecologists, and clinical researchers. Finally, in order to understand some of the pathophysiologic basis underlying lower urinary tract dysfunction, biologic information was obtained and analyzed from patient samples and imaging. After a successful initial 5-year funding cycle, LURN is prepared to build on the knowledge gained and take the next steps with the following Specific Aims: 1) To test and refine the original clustering model with a cohort including a wider range of symptom severity and a wider range of physiological measures, 2) To identify protein biomarker signatures contained within plasma that can be used to identify specific subgroups of men and women with LUTS 3) To determine phenotypic characteristics of women with lower urinary tract symptoms (LUTS) by measuring the functional components of the lower urinary tract, 4) To validate a comprehensive outcome tool for men and women with LUTS, and 5) To determine the role of psychosocial stress ? especially adverse childhood experiences ? in the severity and course of LUTS. The LURN II will recruit 1380 patients, stratified by sex. Our site will recruit 1/6 of these participants (N = 230). We have a multi-method approach to phenotyping patients with LUTS, which will include questionnaires, laboratory tests, mobile apps, and urodynamics of the bladder and urethra. Data will be analyzed using resampling-based cluster analyses, as well as longitudinal modelling of symptoms over time. We hypothesize that our biopsychosocial approach to assessing patients with LUTS will yield clinically- meaningful patient clusters, which in turn can be linked to causal mechanisms as well as treatment options. Moreover, we hypothesize that modifiable risk factors will be related to the course of LUTS over time, creating novel avenues for treatment. The impact of this study will lend itself to an improved understanding of the causes and nature of LUTS, which will set the stage for clinical trials to improve quality of life for these patients.

Public Health Relevance

This application is for the continuation of the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN), which was assembled in 2012 to increase our understanding of lower urinary tract symptoms (LUTS) by identifying important subtypes of patients with LUTS, and improving the measurement of patient experiences of LUTS. In this renewal application ? LURN II ? we plan to refine our ability to subtype patients by developing a biomarker panel that can be used in a clinical setting to phenotype patients, as well as through other patient assessment data gleaned from questionnaires, mobile apps, and laboratory-based testing. Building upon LURN I, we will further interrogate the structure and function of the bladder and urethra with a comprehensive battery of urodynamic tests, which will add to a biopsychosocial understanding of the causes and nature of LUTS.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01DK097779-07
Application #
9823065
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Mullins, Christopher V
Project Start
2012-09-30
Project End
2024-08-31
Budget Start
2019-09-11
Budget End
2020-08-31
Support Year
7
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Northwestern University at Chicago
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611
Helfand, Brian T; Smith, Abigail R; Lai, H Henry et al. (2018) Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study. J Urol 200:397-404
Andreev, Victor P; Liu, Gang; Yang, Claire C et al. (2018) Symptom Based Clustering of Women in the LURN Observational Cohort Study. J Urol 200:1323-1331
Cameron, Anne P; Lewicky-Gaupp, Christina; Smith, Abigail R et al. (2018) Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study. J Urol 199:1023-1031
Griffith, James W; Messersmith, Emily E; Gillespie, Brenda W et al. (2018) Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study. J Urol 199:528-535
Helmuth, Margaret E; Smith, Abigail R; Andreev, Victor P et al. (2018) Use of Euclidean length to measure urinary incontinence severity based on the lower urinary tract symptoms tool. Am J Obstet Gynecol 218:357-359
Lai, H Henry; Naliboff, Bruce; Liu, Alice B et al. (2018) The LURN Research Network Neuroimaging and Sensory Testing (NIST) Study: Design, protocols, and operations. Contemp Clin Trials 74:76-87
Siddiqui, Nazema Y; Wiseman, Jonathan B; Cella, David et al. (2018) Mental Health, Sleep and Physical Function in Treatment Seeking Women with Urinary Incontinence. J Urol 200:848-855
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Bradley, Catherine S; Erickson, Bradley A; Messersmith, Emily E et al. (2017) Evidence of the Impact of Diet, Fluid Intake, Caffeine, Alcohol and Tobacco on Lower Urinary Tract Symptoms: A Systematic Review. J Urol 198:1010-1020
Yang, Claire C; Weinfurt, Kevin P; Merion, Robert M et al. (2016) Symptoms of Lower Urinary Tract Dysfunction Research Network. J Urol 196:146-52