About
Bladder and Prolapse
Problems
NIH Research Awards
R E S E A R C H A C T I V I T I E S
NIH Research Awards
Current Grants
Specialized
Center of Research (SCOR) on Sex an Gender Factors Affecting Women' s
Health; National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK). Principal Investigator: Jeanette S. Brown, MD; Co- Principal
Investigator: Tom Lue, MD.
This program project, the UCSF SCOR on lower urinary tract function in
women will provide the organizational structure to further develop and
support multi-disciplinary, collaborative research projects from both
basic and clinical investigators. The UCSF SCOR will also strengthen a
productive existing program of multidisciplinary research including researchers
from the Departments of Obstetrics, Gynecology, and Reproductive Sciences,
Urology, Epidemiology, and Family Medicine. Working as a single administrative
unit, the UCSF SCOR will provide an efficient mechanism for development
and completion of collaborative, multi-institutional, multi-disciplinary
research, enhancing the productivity of our group of investigators. This
"bench to bedside" collaborative research paradigm will facilitate
direct translation of scientific results to improved patient care. (RFA-OD-02-002;
10/02 - 9/07)
Urinary
Incontinence: Reproductive/Hormonal Factors; NIDDK. Principal Investigator:
David Thom, MD, PhD; Co-Investigators: Steven van den Eeden, PhD and Jeanette
S. Brown, MD.
To determine the association between specific childbirth variables, hysterectomy,
hormone use and subsequent urinary incontinence. 2100 ethnically diverse
women ages 40 to 69 will be enrolled. Incontinence will be assessed by
a detailed in-person interview and specific potential risk factors associated
with parturition, including vaginal delivery, use of forceps, episiotomy,
and infant birth weight will be abstracted from the labor and delivery
records. (RO1-DDK5335; 11/98-10/02)
Urinary
Incontinence: Reproductive/Hormonal Risk Factors; NIDDK. Principal Investigator:
David H. Thom, MD, PhD; Co-Investigators: Steven van den Eeden, PhD and
Jeanette S. Brown, MD.
This study will ascertain the incidence of and risk factors for urinary
incontinence in a well-characterized cohort of 2100 racially and ethnically
diverse middle-aged and older women. Risk factors of special interest
include parturition variables, hormones, pelvic surgeries, pelvic organ
prolapse, obesity, urinary tract infections, and physical activity. Additional
studies will be performed to assess the relationship between serum estradiol
levels and urinary incontinence in a nested case-control study and to
compare utilization of medical services and costs of care for women with
urinary incontinence to continent women. (SCOR R01; 10/02 - 9/07)
Reproductive
Risk Factors for Pelvic Organ Prolapse; National Institute of Child Health
and Human Development (NICHD). Principal Investigator: Jeanette S. Brown,
MD; Co-Investigator: David Thom, MD, PhD.
A 1100 woman population-based sample will be objectively assessed for
pelvic organ prolapse to determine the prevalence of prolapse by vaginal
segment and severity (Stage I-IV), and age group. The ethnic diversity
of study subjects will allow comparison of prevalence estimates between
major ethnic groups. Additional aims are to determine the association
between specific aspects of parturition and development of prolapse in
later life; to ascertain the association between hysterectomy (type and
indication) and subsequent prolapse; to identify other potential risk
factors for prolapse, especially those that are preventable or modifiable;
and to describe the associations of pelvic organ prolapse with urinary
and fecal incontinence. Identification of risk factors for prolapse will
help guide the development of preventive intervention trials to test the
efficacy of modifying risk factors for pelvic organ prolapse. (R01- HD-41134;
9/01-8/05)
Diabetes
Prevention Program (DPP) Urinary Incontinence Study; NIDDK. Principal
Investigator: Jeanette S. Brown, MD.
The DPP is a 3234 participant randomized trial of interventions to prevent
the development of diabetes in adults with glucose intolerance. An ancillary
urinary incontinence study will be implemented at the end-of-study visit
beginning January 2002. The primary objective is to determine if glucose
intolerance, like frank diabetes is a risk factor for incontinence. Most
importantly, we will be able to determine if interventions that reduce
the risk of developing diabetes also reduce the risk of developing incontinence.
The DPP has been funded for long-term follow-up of the cohort. The urinary
incontinence study has been approved to repeat incontinence measures in
the long-term cohort study. (5U01; DK 48489; 7/01-6/02)
Action
for Health in Diabetes (Look AHEAD): Urinary Incontinence Study; NIDDK.
Principal Investigator: Jeanette S. Brown, MD.
The Look AHEAD is a randomized trial to test the effect of weight reduction
vs. control on cardiovascular events in 5000 obese participants with type
2 diabetes. An incontinence study has been approved and funded to be implemented
at baseline and for annual evaluations (approximately 12 years of follow-up).
The primary objective is to determine if weight loss reduces the development
or severity of urinary incontinence among obese type-2 diabetics. Most
importantly, we will be able to determine if interventions that reduce
weight and potentially changes in health risk and disease progression
also reduce the risk of developing incontinence. (NIDDK Cooperative Agreement
DK 57136; 9/01-8/06)
Diabetes
and Urinary Incontinence. K-24 Mid-career Investigator Award in Patient
Oriented Research; NIDDK. Principal Investigator: Jeanette S. Brown, MD.
The study will determine among women with diabetes: prevalence and incidence
of urinary incontinence by type (urge, stress, and mixed) and severity,
both overall and by race; risk factors associated with incontinence, especially
aspects of diabetes severity (duration, treatment, glycemic control, presence
of microvascular complications including retinopathy, nephropathy and
neuropathy) that are associated with greater risk or severity of urinary
incontinence; and whether interventions including glycemic control or
weight reduction prevent or reduce severity of urinary incontinence among
women with diabetes. Questionnaire, laboratory, and outcome data from
a triad of diabetes studies that include women with impaired glucose tolerance,
type 2 and type 1 diabetes and 2 population-based cohort studies that
include women with and without diabetes will be analyzed. (PA-98-053;
10/02-5/06)
Epidemiology
of Diabetes Interventions & Complications (EDIC), Uro-EDIC Study.
Principal Investigator: Jeanette S. Brown, MD.
In April 2001, representatives from the NIDDK Division of Kidney, Urologic,
and Hematologic Diseases (DKUHD) and the Division of Diabetes, Endocrinology
and Metabolic Diseases (DEM) convened a meeting of experts in sexual function,
urinary incontinence (Dr. Brown, Chair), and urinary tract infections.
The meeting included discussion of the current state of knowledge, gaps
in knowledge, and future directions for research in urologic complications
among diabetics. The group identified the EDIC Study as an important cohort
study to develop an ancillary study proposal to determine urologic outcomes
in men and women with type 1 diabetes. A proposal for the Uro-EDIC has
been approved from the EDIC study and the study will begin September 2002.
Diabetes:
Lower Urinary Tract Dysfunction and Infections; NIDDK. Principal Investigator:
Jeanette S. Brown, MD; Co-Investigators: Steven van den Eeden, PhD and
David H. Thom, MD, PhD.
The proposed longitudinal follow-up of the RRISK cohort, including 400
women with type 2 diabetes, offers a unique and efficient opportunity
to understand the natural history and possible mechanisms for lower urinary
tract dysfunction and urinary tract infections in women with and without
type 2 diabetes. Lower urinary tract dysfunction will be precisely evaluated
using postvoid residual, uroflow, and urodynamic testing, as well as validated
questionnaires, diaries, and laboratory data. A better understanding of
risk factors for and pathogenesis of lower urinary tract dysfunction and
urinary tract infections will help guide the development of preventive
interventions, especially for women at higher risk because of type 2 diabetes.
(SCOR R01; 10/02 - 9/07)
Economic Analysis of the Program to Reduce Incontinence by Diet and Exercise (E-PRIDE) (1 R01 DK070196-01A1). To evaluate the costs, health-related quality of life and cost-effectiveness of the diet and exercise program compared to a standard informational pamphlet on frequency of urinary incontinence. E-PRIDE is an ancillary study to the PRIDE, a 330 participant randomized clinical trial evaluating weight reduction to treat obese women with urinary incontinence. The E-PRIDE will conduct cost-utility analysis of randomization to a weight reduction program versus control to treat incontinence. (PI: Subak, LL; 7/1/05–7/31/08)
Program to Reduce Incontinence by Diet and Exercise (PRIDE) (1
U01 DK067860-01). To determine the effect of a diet and exercise
program on urinary incontinence among overweight and obese women with
incontinence. PRIDE is a 330 participant randomized clinical trial evaluating
weight reduction to treat obese women with urinary incontinence. Women
will be randomized to a 6 month weight reduction program or usual care
group without weight reduction followed by a second randomization to an
enhanced or a standard weight maintenance strategy and 18 month follow-up.
This study will determine whether randomization to a behavioral weight
control program results in greater improvement in continence compared
to usual care and identify women most likely to experience improved continence
after weight reduction. We will also evaluate an enhanced, motivationally-focused
weight maintenance program compared to a standard, skill-based maintenance
program or usual care for weight loss, sustained improvement in continence,
and improvement in quality of life. UCSF will be the Coordinating Center
for the two site trial. (PI: PI: Subak, LL; 8/1/03–7/31/08)
Molecular
mechanisms of female stress urinary incontinence; NIDDK. Principal Investigator:
Tom F. Lue; Co-Investigator: Ching S. Lin, PhD.
The major goal of this project is to investigate the effect of birth trauma,
ovariectomy and aging on the female continence mechanism. (R01 DK 51374;
12/98-11/02)
Regeneration
of functional smooth muscle tissue; NIDDK. Principal Investigator: Emil
A. Tanagho, MD, Co-Investigator: Tom F. Lue.
The major goal of this project is to investigate the cellular and molecular
mechanisms of growth factor mediated regeneration of acellular bladder
matrix using both in vitro and in vivo models and its potential clinical
use. (R01 DK 51101; 1/01-12/04)
Urinary
Incontinence: Molecular Mechanism and Matrix-based therapy; NIDDK. Principal
Investigator: Tom Lue, MD; Co- Investigators: Ching Lin, PhD and Emil
Tanagho, MD.
This study will identify the genes that are associated with stress urinary
incontinence in a rat model resulting from pregnancy/delivery, birth trauma
and ovariectomy. In addition, the researchers will identify growth factors
that can enhance angiogenesis, neural and muscular growth in a novel in
vitro system. Once the ideal growth factor combinations are identified,
the researchers will explore the potential of curing stress urinary incontinence
with acellular matrix treated with and without growth factors. (SCOR R01;
10/02 - 9/07)
Completed Grants
Prevalence,
incidence, and associated risk factors for urinary incontinence; National
Institute of Aging, Mentored Clinical Scientist Development Award; NIDDK.
Principal Investigator: Jeanette S. Brown, MD.
To determine risk factors for urinary incontinence and to test the effectiveness
of hormone therapy for urinary incontinence in elderly women. The identification
of risk factors will guide the development of randomized trials of the
efficacy of preventable or modifiable factors. The research on hormone
replacement therapy will provide definitive data on the efficacy of hormone
therapy to prevent the development of urinary incontinence and as treatment
for incontinence. (KO8-AG 00710; 5/97-5/01)
Women's
Reproductive Health Research Career Development (WRHR); NICHD/OWHR. Scholar:
Leslee L. Subak, MD.
The purpose of the UCSF WRHR is to recruit and prepare outstanding candidates
to acquire the new skills they will need to achieve our principal mission:
to promote health and prevent disease in women by expanding the pool of
well-trained, imaginative, productive investigators in the field of women's
reproductive health. The primary focus of Dr. Subak's research is investigating
the clinical effectiveness and cost-effectiveness of medical care for
female urinary incontinence and pelvic floor disorders. Understanding
the impact of incontinence symptoms and costs on women's lives and the
effectiveness, costs, and cost-effectiveness of treatment will facilitate
the development of evidence-based management guidelines, with the long-term
goal of improving quality of life for women with incontinence and pelvic
floor disorders. (K12 HD01262-02; 1/99-12/03)
Stress
urinary incontinence: costs, utilities and cost-effectiveness of treatment;
ancillary study to the Urinary Incontinence Treatment Network (UITN);
NIDDK. Principal Investigator: Leslee L. Subak, MD.
The UITN is a 500 participant randomized clinical trial to compare Burch
and sling procedures to treat women with stress incontinence. A study
has been approved and funded to evaluate the costs of routine care and
treatment for urinary incontinence. In addition, we will quantify utilities
for incontinence health states, willingness-to-pay for improvement in
incontinence, and the cost-utility of the two treatment strategies. (U01
DK58229; 7/01-6/06)
Questions
or comments about this Web site may be sent to
coe@obgyn.ucsf.edu.
Last updated:
09/15/2009
