Using the cooperative agreement mechanism, the NICHD Contraception and Reproductive Health Branch created the Pelvic Floor Disorders Network, which consists of seven clinical sites and one data-coordinating center.  The first Network protocol is the Colpopexy and Urinary Reduction Efforts Study, a randomized trial to determine whether continent women with advanced prolapse should receive a procedure to prevent stress incontinence (called the Burch colposuspension) at the same time that abdominal sacral colpopexy is performed to correct prolapse.

The second protocol is the Childbirth and Pelvic Symptoms (CAPS) Study, which will determine the prevalence and incidence of fecal incontinence, urinary incontinence, and sexual dysfunction in women after childbirth.  The study will follow three groups of women after the delivery of their first child:  400 women after vaginal delivery with anal sphincter laceration, 400 women after vaginal delivery without anal sphincter laceration, and 100 women after cesarean delivery without labor.  This study is the largest ever performed with American women; because obstetric practices in Europe, especially the use of midline episiotomy, vary so widely, data comparisons cannot be used to estimate the occurrence of symptoms after childbirth.  The results of this study will be important in identifying risk factors for pelvic floor disorders after delivery; in addition, these data will be used to design a trial of pelvic muscle physiotherapy to prevent or treat fecal incontinence and other symptoms after childbirth.  Enrollment of the full sample is complete. 

For more information about the Pelvic Floor Disorders Network, visit http://www.med.umich.edu/borc/PFDN_public/jsp/PFDN_public.htm.