A comprehensive approach to the study of continence mechanics

尽管七分之一的女性受到压力性尿失禁的影响，但这种情况的根本原因尚不清楚。直到最近，人们认为骨盆底肌肉的虚弱或损伤是压力性尿失禁发展的主要因素。 最近的研究表明，在评估尿失禁的存在或严重程度时，结缔组织和尿道壁（尿道括约肌）中嵌入的肌肉的损伤可能比骨盆底肌肉的损伤更重要。 测量骨盆底肌肉、结缔组织和尿道括约肌的结构完整性，直到最近，在没有侵入性技术如手术或昂贵的技术如磁共振成像（MRI）的情况下是不可能的。 由于超声成像系统技术的进步，这些措施现在可以廉价和非侵入性地完成。 我们建议使用超声成像来调查盆底肌肉，盆腔结缔组织的完整性和尿道括约肌的体积，然后使用动态超声成像来研究这些结构的缺陷对外在尿道系统功能的影响。这项研究将帮助我们了解尿道系统如何以及为什么会失败，从而确定在存在不同缺陷的情况下，什么干预措施可能是最有效的治疗压力性尿失禁。 申请人有所有必要的运营资金来进行这项研究计划，但需要设备资金来购买可用于进行必要测量的超声系统。 获得这一系统将使申请人目前的学员受益匪浅，因为他们的论文工作需要超声成像，并将有助于申请人吸引高素质的学员和强大的国际合作者，因为她的实验室将配备理想的设备，以进行最先进的研究，不同的缺陷对生物力学的相对重要性的机器人机制。

Despite the fact that one in seven women is affected by stress urinary incontinence, the underlying cause of of this condition is poorly understood. Until recently it was thought that weakness of or damage to the pelvic floor muscles was a major factor in the development of stress urinary incontinence. Recent studies have suggested that damage to the connective tissues and to the muscles embedded in the urethral wall (the urethral sphincters) may be more important than damage to the pelvic floor muscles when evaluating the presence or severity of incontinence. Measuring the structural integrity of the pelvic flloor muscles, connective tissues and urethral sphincter muscles, until recently, has not been possible without invasive techniques such as surgery, or expensive techniques such as magnetic resonance imaging (MRI). Because of advances in the technology of ultrasound imaging systems, these measures can now be accomplished inexpensively and non-invasively. We propose to use ultrasound imaging to investigate the pelvic floor muscles, the integrity of the pelvic connective tissues and the volume of the urethral sphincters and to then use dynamic ultrasound imaging to study the impact of defects in these structures on the function of the extrinsic continence system. This research will help us to understand how and why the continence system fails and consequently to determine what interventions may be most effective to treat stress urinary incontinence in the presence of different deficits. The applicant has all of the necessary operating funds to pursue this research program, but is in need of equipment funding to purchase an ultrasound system that can be used to make the necessary measurements. Acquiring this system would benefit the applicant's current trainees immensely, since their thesis work requires ultrasound imaging, and would help the applicant to attract highly qualified trainees and strong international collaborators, since her laboratory would be ideally equipped to peform state of the art studies on the relative importance of different defects on the biomechanics of the continence mechanism.