Grant: Research Tools and Instruments - Category 1 (<$150,000)

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.