MUSCLE MATRIX AND BLADDER FUNCTION

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DESCRIPTION: (Adapted from the applicant's abstract) Urinary incontinence is a problem for an estimated 10 million Americans of all ages, and is a leading cause for institutionalization of the elderly. Bladder outlet obstruction secondary to benign prostatic hypertrophy (BPH) is also a major medical issue facing the nation when one considers that 10 billion dollars (a conservative figure for 400,000 prostatectomies) is spent yearly on surgical management of the disease. The major symptoms of BPH are secondary to the effects of obstruction on bladder smooth muscle. The annual cost to the nation for these 2 medical problems is estimated to be 20 billion dollars. Many of these symptoms of bladder dysfunction could be managed medically, but the current pharmacologic agents available are outdated and not effective enough. There is a need for more basic science research to understand how bladder smooth muscle develops in the normal fetal and newborn period, how it changes with aging (in both males and females), and how it responds to obstruction. The purpose of the proposed conference is to bring together the major research groups in bladder smooth muscle physiology for an exchange of ideas and information. A field of 20 primary speakers (most of whom have been working in lower urinary tract physiology for at least 3 years) will present their laboratory's work for 30 minutes followed by a brief discussion period. There will be 4 open 45 minute panel discussions. The goal is to provide each primary speaker with a forum to discuss their ongoing work in detail, and receive in depth constructive feedback from their fellow panelists and the audience. A poster session will be arranged to attract work from young or new investigators to the field. All investigators who attend will be invited to contribute their work to a monograph which will be published by Plenum. The conference will be unique for several reasons: 1) there has never been such an in depth conference devoted solely to the topic of smooth muscle function of the lower urinary tract; 2) it will cover the changes in normal bladder physiology that occur beginning in the fetus and on through normal growth and maturation; 3) it will cover in detail the current understanding of the effects of outlet obstruction on smooth muscle function; and 4) in addition to discussing the intracellular basis for smooth muscle function, this conference will also focus in on the role of the extracellular matrix and how it may influence the active and passive properties of the urinary bladder.