Dr. Vivian Pinn (second from r), ORWH director, greets seminar speakers (from l) Dr. Jeannette Brown of the University of California, San Francisco; Dr. Scott Hultgren of Washington University Medical School; and Dr. John DeLancey of the University of Michigan Medical School.

The Office of Research on Women’s Health recently held a Women’s Health Seminar Series on Sex and Gender in the Urinary Tract. The 2008 seminar series has featured principal investigators from the Specialized Centers of Research on Sex and Gender Factors Affecting Women’s Health, an ORWH interdisciplinary initiative.

Opening the seminar, NIDDK director Dr. Griffin Rodgers said, “Women are disproportionately affected by many benign urologic diseases. Women are 7 times more likely than men to have the disorder and urinary incontinence costs consumers more than $15 billion per year. Factors that cause incontinence in women include giving birth, having a muscle injury or pelvic floor dysfunction, and aging. For men the primary causes are prostate surgery, obstruction and aging.”

Rodgers noted several NIH initiatives on urologic health, including the Urinary Incontinence Treatment Network, the Pelvic Floor Disorders Network and the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network.

Dr. Scott Hultgren, director of the Center for Women’s Infectious Disease Research at Washington University Medical School, emphasized the recurrence rate for urinary tract infections (UTIs) in women is 30 to 40 percent. This high rate of recurrence can be explained by bacteria attaching to the surface tissue of the bladder and forming reservoirs in the bladder that serve as a breeding ground for bacteria to seed and cause repeated infection. He said treatment for persistent UTIs should include the use of a strong class of antibiotics at the first sign of symptoms.

Dr. John DeLancey, director of the Fellowship in Female Pelvic Medicine and Reconstructive Surgery, University of Michigan Medical School, presented his work on stress urinary incontinence (SUI). Incontinence due to coughing, laughing, sneezing or anything that increases pressure on the bladder, SUI is primarily due to a decrease in the maximal urethral closure pressure. This pressure decreases each year as we age. Future treatments, he explained, may include injecting stem cells into the bladder so that muscle fiber can be repopulated. Health care providers also need to take preventive measures in the delivery room to preclude the onset of SUI following the birth process.

Diet and exercise can prevent or prolong the onset of diabetes and decrease the risk of many other health problems. Dr. Jeanette Brown, director, Women’s Continence Center, University of California, San Francisco, explained her study of a 6- to 12-month lifestyle intervention that demonstrated weight loss also decreased urinary incontinence by 25 to 46 percent. She said, “Weight-loss benefits of decreased cholesterol and blood pressure may not be immediately observed, but urinary incontinence is a unique motivator for weight loss since the effect is immediate.”