The GHDB supports research on pelvic floor disorders, which affect the reproductive system and other pelvic organs. According to the National Health and Nutrition Examination Survey, pelvic floor disorders affect almost one-quarter of women between ages 20 to 80. The most common condition is urinary incontinence, followed by fecal incontinence, and then pelvic organ prolapse.
According to a recent NIH State-of-the–Science Conference on Prevention of Fecal and Urinary Incontinence in Adults (December, 2007), consequences of urinary and fecal incontinence extend beyond physical manifestations. Individuals affected by these conditions can withdraw from their social lives and hide the condition from families, friends, and even their physicians. The conference summary also states that these conditions are more common in women and that they increase with age. In light of the aging U.S. population, the number of women with pelvic floor disorders is expected to increase substantially in the future.
In many cases, clinicians caring for women with pelvic floor disorders have adopted principles of care and surgical techniques before rigorous, objective, controlled evaluation has taken place. New devices and techniques have had a dramatic influence on surgical practice and in some cases, use has dropped off or switched to a newer replacement after experience has failed to support their usefulness or has shown unexpected consequences. Regional and international dissimilarity in surgical practice without good evidence for differences has also complicated the development of treatment guidelines. A range of treatments, both surgical and non-surgical, exists for these conditions. Research suggests that 11% of women will undergo surgery for urinary incontinence or pelvic organ prolapse during their lifetime, and 30% of those having surgery will undergo at least two surgical procedures to try and correct the problem. Treatment data for fecal incontinence is scarce and incomplete as fecal incontinence is often not identified due to social stigma and therapies have not in general been studied. Thus, although the national cost burden related to pelvic floor disorders is large in terms of direct health care costs, lost productivity, and decreased quality of life, treatments are not supported by good quality evidence. Additionally, failure rates, complications, and lack of data on cost-effective therapies contribute to the financial burden.
The scientific knowledge to be achieved through research directed at pelvic floor disorders will include accumulation of good quality evidence to inform specific rather than empiric methods for prevention, diagnosis, and treatment of pelvic floor disorders. This knowledge will be obtained by incorporating research on standard treatments as well as testing new therapies and approaches to move the research agenda forward in novel directions. Particular attention will be paid to developing innovative solutions to the challenging problems in women with pelvic floor disorders and to reduce the burden of pelvic floors disorders for women and their families.