Through its intramural and extramural organizational units, the NICHD supports and conducts research on urinary tract health. Short descriptions of this research appear below.
The NICHD's research efforts focus on the diagnosis and prevention of urinary tract infections (UTIs) and urinary incontinence (UI).
The Gynecologic Health and Disease Branch (GHDB) funds research on pelvic floor disorders (PFDs). These occur when the muscles and connective tissues of the pelvic area weaken or are injured and include UI. Branch research on UI is:
Researchers also are examining the impact of obesity on UTIs. They have found that elevated body mass index (BMI) increases the risk for UTI and pyelonephritis, a kidney infection caused by bacteria traveling to the kidney from the bladder. Their results can help guide weight loss treatment to prevent UTIs, but more studies are needed to determine a causal relationship between obesity and UTI. (Source: Semins, M. J., Shore, A. D, Makary, M. A, Weiner, J., Matlaga, B. R.(2012). The impact of obesity on urinary tract infection risk. Urology, 79: 266-–269. PMID: 22130358)
In addition, the Section on Epigenetics and Development, part of the Division of Intramural Research (DIR), conducts research that includes the study of girls and women with Turner Syndrome (TS), a condition in which a female is partially or completely missing an X chromosome. Congenital malformations of the urinary tract are found in up to 30% of patients with TS. Many of these abnormalities are not clinically significant, but some may result in increased risk of UTIs.
The NICHD participated in a consensus workshop to develop recommendations for diagnosing and managing TS. The resulting recommendations of an independent panel of experts called for patients to be evaluated for renal abnormalities after receiving a TS diagnosis. Women found to have such abnormalities should then receive a renal ultrasound study and urine culture every 3 to 5 years. They may also need to be screened for UTIs more often. (Source: Saenger, P., Wikland, K. A., Conway, G. S., Davenport, M., Gravholt, C. H., Hintz, R., et al. (2001). Recommendations for the diagnosis and management of Turner syndrome. Journal of Clinical Endocrinology & Metabolism, 86: 3061–3069. PMID: 11443168)
The Spinal Cord and Musculoskeletal Disorders and Assistive Devices (SMAD) Program, part of the NICHD’s National Center for Medical Rehabilitation Research, is studying individuals with neurogenic bladder after spinal cord injuries (SCI) and recurrent UTIs in these patients. In one SMAD Program-supported project, researchers seeded the bladder with benign bacteria (Escherichia coli HU2117) to out-compete pathogenic strains and prevent their growth. Follow-up studies are ongoing, but preliminary results show that the E. coli safely reduces the risk of UTI in patients with SCI. (Source: Darouiche, R. O., et al. (2011). Multicenter randomized controlled trial of bacterial interference for prevention of urinary tract infection in patients with neurogenic bladder. Urology, Aug;78(2):341-6. PMID: 21683991)
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