NICHD Pelvic Floor Disorders Network

描述（由申请人提供）：本申请描述了德克萨斯大学西南（UT西南）医学中心和帕克兰医院的泌尿妇科和泌尿外科教师和研究团队的资格和经验，以及可用于执行骨盆底疾病网络赞助的临床方案的设施和患者人群。2004年，有2 100多名妇女在我们的诊所就诊，617名妇女接受了骨盆底疾病矫正手术。自1997年以来，妇产科和泌尿科的合作日益加强，为患有骨盆底疾病的妇女提供全面护理。除了泌尿妇科学和泌尿外科，合作还包括结直肠外科，放射学，物理治疗和母胎医学的教师。本申请中描述的临床研究团队在NIH申办的国家多中心试验中具有成功的既往和持续经验。该申请的中心是两个现有的研究诊所，一个针对私人患者（由泌尿科经营），另一个专注于医疗贫困患者（由妇产科经营）。本申请还包括一项随机试验的概念申请，旨在评估分娩期间肛门外括约肌撕裂的端对端与重叠修复的疗效。主要结局是肛门失禁，这是此类撕裂伤的重要后果。这项试验将允许准确评估特定外科手术的结果，这是导致创建骨盆底疾病网络的主要兴趣领域之一。我们认为，沿着预防分娩时肛门括约肌撕裂的策略，也应该研究括约肌撕裂的最佳处理，因为在美国每年有20多万妇女遭受这种骨盆底损伤。

DESCRIPTION (provided by applicant): This application describes the qualifications and experience of the urogynecology and urology faculty and research teams at the University of Texas Southwestern (UT Southwestern) Medical Center and Parkland Hospital and the facilities and patient population available to carry out clinical protocols sponsored by the Pelvic Floor Disorders Network. In 2004, there were more than 2,100 women with pelvic floor disorders seen in our clinics and 617 women underwent surgical procedures for correction of pelvic floor disorders. The Departments of Obstetrics and Gynecology and Urology have increasingly collaborated since 1997 to offer comprehensive care of women with pelvic floor disorders. In addition to urogynecology and urology, collaboration includes faculty from colorectal surgery, radiology, physical therapy, and maternal-fetal medicine. The clinical research teams described in this application have successful prior as well as on-going experience in NIH sponsored national multi-center trials. Centerpieces in this application are two existing research clinics, one targeted at private patients (operated by the Urology Department) and the other focused on medically indigent patients (operated by the Obstetrics and Gynecology Department). Also included in this application is a concept application for a randomized trial designed to assess the efficacy of end-to-end versus overlapping repair of the external anal sphincter lacerated during childbirth. The primary outcome is anal incontinence which is a significant consequence of such lacerations. This trial would permit accurate evaluation of the outcome of specific surgical procedures which is one of the prime areas of interest leading to creation of the Pelvic Floor Disorders Network. We are of the view that along with strategies for prevention of anal sphincter laceration during childbirth, optimal management of the torn sphincter should also be studied since more than 200,000 women sustain such pelvic floor injuries each year in the United States.