In my Urological Biomechanics Laboratory, we investigate female pelvic floor dysfunction (FPFD), including stress urinary incontinence (SUI), fecal incontinence (FI), and pelvic organ prolapse (POP). FPFD often results from the maternal injuries of childbirth. We investigate the nature of maternal birth injuries and the post-injury healing process with the goal of improving prevention and treatment of FPFD. We have developed animal models of FPFD that simulate the maternal injuries of childbirth. We use genetic mouse models to investigate how genetic factors play a role in FPFD development. In collaboration with Dr. Marc Penn, we are investigating if homing of innate stem cells facilitates recovery from simulated childbirth injuries. This application of stem cell technology to facilitate injury recovery could help prevent and treat FPFD. In collaboration with Massarat Zutshi we have developed an animal model of FI and are using it to test methods of treatment and prevention. We are also developing devices for improved diagnosis and treatment of FPFD and have developed a simulation of the effects of cough on the bladder and pelvic floor. We are developing a functional virtual reality model of the human pelvic floor for use in research, teaching, and surgical simulation. We expect that this multifactorial approach will lead to improved methods of diagnosing and treating FPFD.
In other words ...
We investigate female pelvic floor dysfunction (FPFD), including stress urinary incontinence or leakage of urine, fecal incontinence or leakage of stool, and pelvic organ prolapse, in which the genitourinary organs fall out of their appropriate position in the pelvic region. These conditions are common among older women and, in part, are caused by delivery of children. Therefore we study how childbirth causes these conditions and have developed several therapeutic methods for treatment and prevention of these conditions. We use genetic mouse models to investigate how genetic factors play a role in FPFD development. We are also developing devices for improved diagnosis and treatment of FPFD.
Brian Balog B.S.
Kangli Deng M.D.
Mei Kuang M.S.
Senior Research Technologist
Lead Research Technologist
Aref Smiley M.S.
Jun Yang MD, PhD
Gammie A, et al.; The International Continence Society Urodynamic Equipment Working Group. International continence society guidelines on urodynamic equipment performance. Neurourol Urodyn 2014 Jan 4. doi: 10.1002/nau.22546. [Epub ahead of print].
Dissaranan C, et al. Rat mesenchymal stem cell secretome promotes elastogenesis and facilitates recovery from simulated childbirth injury. Cell Transplant 2013 Jul 17 [Epub ahead of print].
Gill BC, et al. Stress incontinence in the era of regenerative medicine: reviewing the importance of the pudendal nerve. J Urol 2013;190:22-8. doi: 10.1016/j.juro.2013.01.082. Review.
Lenis AT, et al. Impact of parturition on chemokine homing factor expression in the vaginal distention model of stress urinary incontinence. J Urol 2013;189:1588-94. doi: 10.1016/j.juro.2012.09.096.
Jiang HH, et al. Effects of acute selective pudendal nerve electrical stimulation after simulated childbirth injury. Am J Physiol Renal Physiol 2013;304:F239-47.
Jiang HH, et al. Bladder dysfunction changes from underactive to overactive after experimental traumatic brain injury. Exp Neurol 2013;240:57-63. doi: 10.1016/j.expneurol.2012.11.012.
Spirka T, et al. Effect of material properties on predicted vesical pressure during a cough in a simplified computational model of the bladder and urethra. Ann Biomed Eng 2013;41:185-94.
Gill BC, et al. Neurotrophin therapy improves recovery of the neuromuscular continence mechanism following simulated birth injury in rats. Neurourol Urodyn 2013;32:82-7. doi: 10.1002/nau.22264.
Cruz M, et al. Pelvic organ distribution of mesenchymal stem cells injected intravenously after simulated childbirth injury in female rats. Obstet Gynecol Int 2012;2012:612946.
Salcedo L, et al. Mesenchymal stem cells can improve anal pressures after anal sphincter injury. Stem Cell Res 2013;10:95-102.
Damaser MS, et al. Electrical stimulation of anal sphincter or pudendal nerve improves anal sphincter pressure. Dis Colon Rectum 2012;55:1284-94. doi: 10.1097/DCR.0b013e31826ae2f8.
Pastelín CF, et al. Neural pathways of somatic and visceral reflexes of the external urethral sphincter in female rats. J Comp Neurol 2012;520:3120-34. doi: 10.1002/cne.23079.
Sajadi KP, et al. Pudendal nerve stretch reduces external urethral sphincter activity in rats. J Urol 2012;188:1389-95. doi: 10.1016/j.juro.2012.06.006.
Vaegler M, et al. Stem cell therapy for voiding and erectile dysfunction. Nat Rev Urol 2012 Jun 19. doi: 10.1038/nrurol.2012.111. [Epub ahead of print].
Couri BM, et al. Animal models of female pelvic organ prolapse: lessons learned. Expert Rev Obstet Gynecol 2012;7:249-260.
Goldman HB, et al. Will we ever use stem cells for the treatment of SUI? ICI-RS 2011. Neurourol Urodyn 2012;31:386-9. doi: 10.1002/nau.22217. Review.
Salcedo L, et al. Low current electrical stimulation upregulates cytokine expression in the anal sphincter. Int J Colorectal Dis 2012;27:221-5. doi: 10.1007/s00384-011-1324-3.