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U Gynecologist Leads Studies to Determine Genetic Factors in Pelvic Floor Disorders


August 2, 2002 — Pelvic floor disorders (PFDs), including pelvic organ prolapse and urinary incontinence, are common problems for women of all ages. But, little is known about the causes of these diseases.

The University of Utah School of Medicine is participating in two studies that will try to determine whether PFDs are inherited.

One, a five-year, $1.7 million study, is funded by the National Institutes of Health (NIH), with Peggy A. Norton, M.D., associate professor of obstetrics and gynecology, as principal investigator. Co-investigators are Kenneth J. Ward, M.D., professor of obstetrics and gynecology and adjunct professor of human genetics, and Sandra J. Hasstedt, Ph.D., associate professor of human genetics.

PFDs affect one-third of adult women in the United States and result in surgery for one in nine women. PFDs include pelvic organ prolapse or hernia (a bulging of the vaginal walls, the uterus or the intestines) and urinary incontinence.


Although urinary incontinence and pelvic organ prolapse are distinct conditions, they frequently occur in the same individual, according to Norton, who leads the medical school’s Division of Urogynecology and Pelvic Reconstructive Surgery.

“This may be because PFDs share some common factors, such as childbirth. Pelvic floor disorders are frustrating to treat and to prevent because we don’t know why women develop these problems,” Norton said. “Understanding the genetic influence on pelvic floor disorders might help us identify women at risk and the genes that may contribute to the development of these problems.”

Initial participants will be recruited from the Utah Continence Center patient database and will be those who have been seen for PFD. The investigators hope to identify patients’ sisters who also have PFD and the two will then be asked to participate in the U trial. Sister pairs will be prioritized according to the severity of their symptoms and risk factors, and the genetic analysis will be completed by Ward’s laboratory. Ward directs the medical school’s Program of Reproductive Genetics.

The second study, also directed by Norton at the U of U, will aim to determine the prevalence of pelvic floor disorders within families. B. Walter Steward, Ph.D., an epidemiologist at Johns Hopkins University, will assist in the study.

According to Norton, this study will extend to families with a history of hernia repairs among male family members. Women with a first-degree male relative with hernia have an increased risk of hernia; with a first-degree female relative, the risk jumps to 14 times normal.


Women from large families living near Salt Lake City are invited to participate. Three generations of full-blooded relatives will be sought. The study will involve questionnaires, examinations and evaluation.