Lower urinary tract symptoms (LUTS) are associated with several syndromes and diagnoses in women, including urinary incontinence, overactive bladder, voiding dysfunction, urinary tract infections, and interstitial cystitis/bladder pain syndrome. These syndromes/diagnoses are common, costly, and lead to significant decreases in quality of life. Despite their common occurrence, however, many of these LUTS are readily preventable and treatable through behavioral or medical/surgical therapy. Several risk factors have been identified for LUTS (e.g., pregnancy and childbirth, later-life overweight/obesity) and several behavioral therapies have been developed to prevent these LUTS in high-risk women (e.g., pelvic floor muscle training in pregnant women) and to reverse or reduce LUTS (e.g., weight loss), offering the promise of both primary and secondary LUTS prevention. However, before we can achieve LUTS prevention, we must address several critical knowledge gaps. These include identification of risk factors for early-onset LUTS to allow prevention opportunities earlier in life; confirmation of additional under-studied risk factors to expand opportunities for prevention; synthesis of the existing literature to highlight research gaps and to help prioritize future research efforts; establishment of healthy bladder behaviors and normal voiding function as a basis for future interven- tions; and a better understanding of patient, provider, and structural barriers (e.g., unclean restrooms) to LUTS prevention to increase the reach and effectiveness of prevention strategies. To address each of these research gaps, we have assembled a portfolio of innovative, collaborative, and multi-site studies (in design or potential) drawing upon the diverse expertise of our multidisciplinary team. Together, our aims address a wide range of risk factors, the full spectrum of LUTS, each of the four lifestages of interest, and each of the objectives for this FOA. Specifically, we propose to: 1) identify risk factors for LUTS (overweight/obesity, habitual amateur high impact physical activity, habitual intake of caffeinated, carbonated, and artificially-sweetened beverages, and traumatic events and abuse) in adolescent girls and young, reproductive age women in the large, unique Growing Up Today Studies 1 and 2; 2) synthesize the existing epidemiologic literature on LUTS risk factors, both qualitatively and quantitatively, and then use this information to highlight remaining research gaps, and identify the most important populations and risk factors to target for prevention; 3) establish the evidence base for normal voiding behaviors and function, document the voiding environment, and examine the influence of acute, modifiable (bowel function, voiding behaviors) and structural factors (voiding environment) on voiding characteristics/acute LUTS; and 4) identify patient, provider, and structural barriers to LUTS prevention across the lifespan through focus groups of patients and providers, and through surveys. Together, our aims will establish the necessary evidence base to initiate future interventional studies of primary and secondary LUTS prevention in adolescents and women, which is the ultimate goal of the Trans-Prevention of LUTS Consortium.
The proposed U01 is relevant to public health because it will establish the necessary evidence base to initiate future interventional studies of primary and secondary lower urinary tract symptom (LUTS) prevention in adolescent girls and women. This objective is critical to reduce the large public health burden of LUTS.
| Harlow, Bernard L; Bavendam, Tamara G; Palmer, Mary H et al. (2018) The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium: A Transdisciplinary Approach Toward Promoting Bladder Health and Preventing Lower Urinary Tract Symptoms in Women Across the Life Course. J Womens Health (Larchmt) 27:283-289 |
