||Overview of NIH Research Objectives: (Benign Urology Research, Networks, Prevention, Bladder Health)
||Prevention of Lower Urinary Symptoms Consortium (PLUS) – Social Determinants for Bladder Health
||Lower Urinary Research Network (LURN) – Tool measurement and development
||Multidisciplinary Approach to the study of Pelvic Pain (MAPP) - Functional MRI for chronic pelvic pain
||Pelvic Floor Disorders Network (PFDN) - Surgical Trials for UI & Prolapse
The National Institute of Health in the United States has supported multiple clinical research networks investigating various aspects of lower urinary tract conditions over the past 2 decades. Dr. Bavendam will provide a brief historical overview of these networks. Representative investigators from the currently funded networks: Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Pelvic Floor Disorders Network (PFDN) and the National Institute of Diabetes and Digestive and Kidney Diseases’ Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP), Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) and Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS) will present innovative aspects of these research efforts.
While the role of social factors in determining health outcomes has long been recognized, only recently has there been intentional investigation appraising the mechanisms and pathways through which social factors impact health. The Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS) adopted a conceptual framework for all of its foundational research that is grounded in the socio-ecological model with attention to societal, organizational and community structures and systems in which individuals and their social networks experience health. The framework forces broad consideration of health determinants in our research, while revealing multi-level intervention opportunities for our national bladder health promotion.
Kevin Weinfurt will discuss the Symptoms of Lower Urinary Tract Dysfunction Research Network’s (LURN) efforts to understand the different measurement needs (e.g. phenotyping, diagnosis, outcome measure) and fill some of the gaps in measurement of lower urinary tract symptoms and their impact on individuals. He will present new data on the LURN Recall study which includes 2 basic sets of comparisons, 1) comparing 1-day, 1-week, and 1-month recall periods and 2) comparing traditional bladder diary to 3-day and 1-week recall periods.
Multi-site clinical research networks have the potential to dramatically improve outcomes in the study of lower urinary tract dysfunction, not only by increasing sample size but also by promoting rigor, reproducibility, and generalizability of results. This is especially true in the relatively nascent field of using neuroimaging to study dysfunction in brain regulation of the human urinary system. Here I describe efforts in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network to develop and deploy a large multi-site neuroimaging study, as well as highlight convergent results that have emerged from the MAPP study.
Holly E Richter
The multi-center Eunice Kennedy Shriver NICHD sponsored Pelvic Floor Disorders Network (PFDN) has been successfully conducting randomized surgical and non-surgical trials that have advanced the field of pelvic floor conditions since 2001. These trials have addressed all female pelvic floor disorders including urinary incontinence, pelvic organ prolapse and fecal incontinence, all of which cause distressing symptoms that impact women’s quality of life and perceived overall health. The network organization offers several advantages to the study of these disorders including recruitment, increased generalizability, decreased bias, centralized oversight and committed investigators. A discussion of select trials will be presented