Utah Continence Treatment Center (CTC)

尿失禁在美国构成了一个常见且重大的公共卫生挑战，这一挑战由于美国的“老龄化”和女性预期寿命的不断提高而不断加剧。尿失禁手术后的结局尚未得到充分评价。因此，无法获得客观、严格获得的数据，这些数据是充分告知患者所必需的，也是重要政策决策的基础。尿失禁治疗网络的长期目标是系统地评价尿失禁常用治疗方法的长期结局。该提案描述了犹他州大学尿失禁中心如果成为美国国家卫生研究院尿失禁治疗中心（CTC）的成员将带来的优势。具体来说，我们将展示犹他州尿失禁中心在评估和治疗尿失禁方面的广泛专业知识，包括非手术和手术方法。我们将进一步证明犹他州控尿中心具有参与或领导多中心临床试验的必要能力，并且犹他州大学健康科学中心的妇产科系在NIH奖项中排名全国第14位，在参与和管理NIH驱动的多中心网络研究方面具有良好的记录。最后，我们建议对两种拟议的手术程序（束式阴道悬吊术与耻骨阴道悬吊术）进行前瞻性随机临床试验，而不是前瞻性队列研究，因为犹他州CTC的三位外科医生可以以相同的专业知识进行两种手术。因此，纳入拟议的犹他州CTC将增加CNON能够完成随机对照试验作为最终结局的可能性。

Urinary incontinence constitutes a common and significant public health challenge in the United States, a challenge that is continuously compounded by the "graying" of America and by the ever improving life expectancy for women. Outcomes following surgery for urinary incontinence have not been ,adequately evaluated. As a result, objective, rigorously-obtained data, required to fully inform patients and on which to base important policy decisions, are unavailable. The long-term objective of the Urinary Incontinence Treatment Network (UITN) is to systematically evaluate the long-term outcomes of commonly utilized therapeutic approaches for urinary incontinence. This proposal describes the strengths that the University of Utah Continence Center would bring if it were to become a member Continence Treatment Center (CTC) of the UITN. Specifically, we will demonstrate the extensive expertise of the Utah Continence Center in the evaluation and treatment of urinary incontinence, including non-surgical and surgical approaches. We will further document that the Utah Continence Center has the- necessary ability to participate in or lead multicenter clinical trials, and that the Department of Obstetrics and Gynecology at the University of Utah Health Sciences Center, 14th'in the nation in NIH awards, has a proven track record in participating and managing NIH-driven multicenter network studies. Finally, we propose to carry out a prospective, randomized clinical trial for the two proposed surgical procedures (Bunch colposuspension versus pubovaginal sling) rather than a prospective cohort study, since the three investigators-surgeons for the Utah CTC can perform both procedures with equal expertise. Thus, inclusion of the proposed Utah CTC will increase the likelihood that the UITN will be in a position to complete a randomized controlled trial as the final outcome.