Female Pelvic Floor Disorders and Sexual Funcitons

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DESCRIPTION (provided by applicant): Pelvic floor disorders (PFDs), including urinary incontinence, fecal incontinence, and pelvic organ prolapse, affect one-third of adult women. These conditions have a profound affect on quality-of-life, resulting in discomfort, embarrassment and functional limitations. In addition, up to 50% of women with PFDs report a problem with sexual function. However, it is unclear whether the sexual complaints of women with PFDs are attributable to PFDs or to other factors (i.e., relationship conflict or co-morbid conditions). Until recently, research on this subject has been hampered by the lack of survey instruments to assess female sexual dysfunction (FSD) and PFDs. Our research objective is to investigate the impact of PFDs on female sexual function. We hypothesize that PFDs are independently associated with FSD and that successful treatment of PFDs will restore sexual function. We propose two specific aims: (1) Using validated instruments, we will determine whether PFDs (urinary incontinence, fecal incontinence, and pelvic organ prolapse) are independently associated with sexual complaints and sexual dysfunction; and (2) among women with urinary or fecal incontinence treated with pelvic muscle physiotherapy, we will determine whether improvement in continence is associated with improvement in sexual function. The NICHD has given high priority to research that increases knowledge about human sexuality, including the impact of illness or disability. This proposal will improve our understanding of sexual function in women with PFDs. It will also serve as a foundation for further research on the impact of non-surgical and surgical interventions on the sexual function of women with PFDs. The proposed research will provide valuable research training and experience for the candidate. Career development during the award will include formal training in epidemiology, biostatistics, and clinical trial design at the Bloomberg School of Public Health. The environment at Johns Hopkins provides a strong infrastructure for clinical research and mentorship by experienced scientists. This powerful combination will provide the candidate with the necessary skills and experience to become a successful, independently funded investigator.