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NIH awards OHSU researcher $1.2 million to determine causes of, risk factors for pelvic floor injury

PORTLAND, Ore. - One of the worlds pre-eminent experts in urogynecology at Oregon Health & Science University has received $1.2 million in grants from the National Institutes of Health to study the extent of pelvic floor injury in women before, during and after pregnancy.

The pelvic floor comprises the muscle group that supports the pelvic organs and maintains bowel continence. Pelvic floor injury, which is caused by damage to pelvic muscles or nerves, can lead to a wide array of disorders, including incontinence and the displacement of organs, also known as organ prolapse.

We hope to be able to determine if some women have inherent characteristics that may make them more susceptible to pelvic floor injury, said W. Thomas Gregory, M.D., F.A.C.O.G., assistant professor of obstetrics and gynecology (urogynecology), OHSU School of Medicine, and member of the OHSU Center for Womens Health. We also hope to be able to conclusively determine whether vaginal birth truly affects pelvic floor strength and coordination; or if there are other factors, such as the pregnancy itself, in play.

In order to map the extent of pelvic floor injury throughout the length of the study, Gregory will use a neurophysiology test frequently used to diagnose injuries or disease outside of the pelvic region, such as carpal tunnel syndrome or amytrophic lateral sclerosis (ALS), commonly known as Lou Gehrigs disease. In this test, a tiny needle inserted into the muscle mass reads the electrical impulses sent by engaged and active muscles; the readings are then examined to determine the function of nerves and muscles in the tested area.

Using this technique to map pelvic floor injury is unusual because it requires training in both neurophysiology and urogynecology, a still nascent subspecialty of obstetrics and gynecology. Gregory is one of the few urogynecologists in the world trained to use this technique.

The need for this kind of research has become increasingly apparent in recent years as a groundswell of health care providers and the public alike have suggested that giving birth via Caesarean section may decrease the risk of sustaining pregnancy-related pelvic floor injuriy. While retrospective studies seem to indicate that this may be the case, this study, to the best of the researchers knowledge, is the first large-scale prospective study to track pelvic floor damage before and after a number of birthing scenarios.

One day we hope to be able to offer women informed choices about preventing pelvic floor disorder - maybe we will find C-sections do reduce the risk of pregnancy-related pelvic floor injuries for some women. Maybe we will find that C-sections do not prevent pelvic floor injury in most women, Gregory said.

Some pelvic floor injury is inevitable throughout a persons lifetime, and disorders resulting from this injury are common among women; recent studies have indicated that one in nine women will at one time undergo surgery to treat the symptoms related to pelvic floor dysfunction.


Contact: Brycie Jones
Oregon Health & Science University

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