Urinary incontinence (UI) is a common problem that diminishes the quality of life in millions of people. The annual cost of treating UI is estimated to be $16 billion making this an economic issue as well. Despite the high prevalence of UI, the evaluation and treatment of UI are not standardized. Outcome data from treating UI are also variable making comparisons among different treatment options difficult. While UI may be due to several etiologies, this proposal will examine the outcomes in surgical management of UI in females. We propose a multidisciplinary approach to standardize this process utilizing a collaborative effort between urologists and urogynecologists who specialize in UI and have published and/or participated in clinical research in this field. These investigators who practice and perform surgeries at University of Maryland Medical Systems (UMMS), Baltimore Veterans Administration Medical Center (BVAMC), Johns Hopkins Hospital (JHH), Johns Hopkins-Bayview Medical Center (JHU-BMC), and Greater Baltimore Medical Center (GBMC) have formed the Baltimore Continence Treatment Center (BCTC). We propose that the BCTC be part of the collaborative network of CTCs selected to participate in long-term cohort studies examining outcomes related to surgical treatment of UI. Because the design of the cohort study already has been developed by the vanguard CTCs, the BCTC proposes these further Specific Aims 1. Maximize total enrollment of UI patients info selected cohort studies through the collaboration of five institutions within the Baltimore metropolitan area; 2. Maximize recruitment of minority subjects through advertisement, public announcements, and public educational programs; 3. Maximize patient retention in cohort studies by financial and other incentives. The blend of academic practices and community-based practice in the BCTC will allow recruitment of a diversity of UI patients that will more accurately reflect the spectrum of care for this problem in the United States.
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