The Truly Healthy Bladder: Understanding Normal As A Pathway To Prevention Of Lower Urinary Tract Symptoms In Women

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 DESCRIPTION (provided by applicant): Many women suffer from life altering lower urinary tract symptoms (LUTS). However, prevention of LUTS is hampered by lack of understanding and definition of true bladder health. The existing paradigm of healthy bladder is too narrowly defined as absence of LUTS, ignoring the World Health admonition that health is NOT JUST absence of disease. To become a nation of women with healthy bladders and reduce high public and private medical care costs, a seismic shift is necessary in how we approach knowledge development about bladder health and subsequently LUTS prevention. We know what LUTS look like (incontinence, urinary tract infection, etc.) but scant literature is availableto guide characterization of the healthy bladder. In this proposal, a broadly interdisciplinary research team with backgrounds in nursing, epidemiology, prevention science, behavioral science, and primary care medicine at the University of Michigan will use our expertise in health promotion and risk reduction to address this knowledge gap. We will characterize bladder health across the lifespan using a process of understanding key intersections of biological and physiological life stages (adolescence, adulthood, childbearing, peri-menopause/menopause, elderly) with psychosocial and behavioral responses to societal messaging about bladder health as experienced by female adolescents, women, parents and primary health care clinicians. The goal is to develop an evidence base about healthy female adolescent's and women's experience of bladder health using novel mixed methods approaches to inform prevention strategies for LUTS. Study aims are: 1. Construct an operational definition of the healthy bladder drawing from expert opinion and concept analysis methods, 2. Further develop/refine/pilot a simple but conceptually novel survey instrument capable of capturing variance within the healthy bladder state. 3. Pilot low-cost developmental projects that will enrich productivity and interdisciplinary collaborations of the Preventing LUTS consortium, including developing fundamental knowledge required for securing funding on investigation of LUTS prevention. More than 1 in 3 US women suffer from the distressing, embarrassing, and often unreported problems of LUTS. This work significantly addresses these challenges by establishing an evidence base of normal ranges and associated covariates for women with healthy bladders across each life stage to lay the foundation for developing rational, effective prevention strategies to reduce the heavy disease burden of LUTS faced by women and society.