Utah Continence Treatment Center (CTC)

尿失禁在美国构成了一项常见而重大的公共卫生挑战，这一挑战因美国的老龄化和女性预期寿命的不断提高而不断加剧。尿失禁手术后的结果还没有得到充分的评估。因此，客观、严格获得的数据是无法获得的，这些数据是充分告知患者所需的，也是重要决策的基础。尿失禁治疗网络(UITN)的长期目标是系统地评估尿失禁常用治疗方法的长期结果。这份提案描述了犹他大学大陆治疗中心如果成为UITN的大陆治疗中心(CTC)的成员将带来的优势。具体地说，我们将展示犹他州大陆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大陆中心具有参与或领导多中心临床试验的必要能力，并且犹他大学健康科学中心的妇产科在NIH奖项中位居全国第14名，在参与和管理NIH驱动的多中心网络研究方面拥有经过证明的记录。最后，我们建议对两种拟议的手术方式(束状悬吊术和阴道吊带术)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的三名研究人员-外科医生可以以同样的专业知识执行这两种手术。因此，纳入拟议的犹他州CTC将增加UITN能够完成作为最终结果的随机对照试验的可能性。

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.