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Causes of pelvic organ prolapse in women and reasons for treatment failure: analysis of existing databases


Project Description

1. Background to the project.
Pelvic organ prolapse is common and often associated with other aspects of pelvic floor dysfunction (urinary and faecal incontinence, and sexual problems). There is little long-term information about the natural history of these conditions, such as incidence and prevalence, resolution and persistence of symptoms1, and there are no data regarding prolapse progression. Nor is there a robust evidence base to guide treatment.
Using already-collected patient data from existing projects within HSRU (PROLONG, POPPY, PROSPECT, VUE and Postnatal Care), extra epidemiological analyses using regression methods will result in new information to produce a fuller picture of the prevalence and antecedents of prolapse and associated pelvic floor dysfunction, and their treatment. The aim of this project is to identify remediable causative factors which might be prevented, factors which may be used to explain treatment effects, and reasons for treatment failure.
The particular strength of this integrated programme of research into the epidemiology, mechanisms and treatment of pelvic organ prolapse is the potential for analysis of long term follow up information from participants who have been identified and consented, and whose data are already available.

2. Proposed research and techniques.
Secondary analysis of already-collected data from a wide variety of studies and trials of women with pelvic floor dysfunction at each stage of disease development will be used to address the following aims:
• To examine the epidemiology of pelvic organ prolapse using data gathered from participants in existing randomised controlled trials and from other relevant surveys;
• To synthesise the data from these sources to identify remediable or predictive factors which can be used for the prevention and treatment of pelvic floor dysfunction.
• To identify confounding factors which can be used to predict treatment success or failure and development of adverse effects.

3. Useful previous experience for the studentship.
1. Evidence of research and statistical experience
2. Familiarity with the clinical area of pelvic floor dysfunction and prolapse in women
3. Understanding of research methodology particularly population epidemiology and randomised controlled trials.


1. Alignment with existing themes:
This proposal includes elements addressing every aspect of the three strategic themes of IAHS, namely: symptoms and early diagnosis, evaluation of healthcare interventions and delivery and, to a lesser extent, delivery and organisation of care.
2. Potential for impact in terms of REF 2021 and future income generation:
1. This research area is significantly neglected and hence has the potential to significantly increase available knowledge
2. It is likely to generate unique and invaluable clinical and research information to improve women’s health and quality of life
3. It is likely to identify further interventions which may be amenable to testing in randomised controlled trials
3. Engagement with other institutions, and patient and public involvement:
Existing collaborations between the University of Aberdeen and Glasgow Caledonian University, University of Birmingham, University of Dunedin (New Zealand). Patient representation has been widely involved in the all the treatment RCTs.
4. Quality of the research supervision.
Dr Lorna Aucott is the Senior Statistician in HSRU. She is an experienced trial statistician and also has extensive knowledge and skills needed for this epidemiological approach.
Professor Glazener is an acknowledged world authority in the field of pelvic floor dysfunction and chief investigator or grant applicant on all the studies and trials which will be included in this research.

APPLICATION PROCEDURE:
This project is advertised in relation to the research areas of APPLIED HEALTH SCIENCE. Formal applications can be completed online: https://www.abdn.ac.uk/pgap/login.php. You should apply for Degree of Doctor of Philosophy in Applied Health Science, to ensure that your application is passed to the correct person for processing.

NOTE CLEARLY THE NAME OF THE SUPERVISOR AND EXACT PROJECT TITLE ON THE APPLICATION FORM.

Candidates should contact the lead supervisor to discuss the project in advance of submitting an application, as supervisors will be expected to provide a letter of support for suitable applicants. Candidates will be informed after the application deadline if they have been shortlisted for interview.

Funding Notes

This project is part of a competition funded by the Institute of Applied Health Sciences. Full funding is available to UK/EU candidates only. Overseas candidates can apply for this studentship but will have to find additional funding to cover the difference between overseas and home fees (approximately £15,680 per annum).

Candidates should have (or expect to achieve) a minimum of a First Class Honours degree in a relevant subject. Applicants with a minimum of a 2:1 Honours degree may be considered provided they have a Distinction at Masters level.

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