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PUMCH’s Research on Female Pelvic Floor Dysfunction Wins the Second Prize of 2019 National Science and Technology Progress Award
CopyFrom: PUMCH UpdateTime: 2020-03-03 Hits: 6 Font Size: SmallBig

On January 10th, 2020, the research project “Establishment and Promotion of A Treatment System for Female Pelvic Floor Dysfunction), with Professor Zhu Lan and Academician Lang Jinghe from Peking Union Medical College Hospital (PUMCH) as its principle investigators, won the second prize of "2019 National Science and Technology Progress Award".

△ The female pelvic floor dysfunction prevention and treatment research group from Peking Union Medical College Hospital. Photographed by Wang Pengfei

Female pelvic organs look like a sail boat, with uterus and vagina at its center, bladder and urethra in the front, and rectum and anus in the back. Muscles and ligaments at the pelvic floor act like slings to support the stable movement of the boat on the water. Once the supporting structures are damaged, a series of embarrassing and distressing pelvic floor disorders such as pelvic organ prolapse and urinary incontinence will occur. With the aging of the population, the prevalence of the aging-related pelvic floor dysfunction (PFD) is increasing rapidly and has become a social issue that seriously affects the health and quality of life of Chinese women.

In the past 15 years, the research team, headed by Dr. Zhu and Dr. Lang, has completed the first epidemiological survey on pelvic floor disorders in China, covering five major diseases that had affected 50,000 patients. It was found that the incidence of urinary incontinence was 30.9% in Chinese adult women, with higher gravidity and parity and old age being its risk factors. Up to now the article has been cited 210 times. Accordingly, a three-level prevention and control model has been established, which is expected to cover 34 province-level jurisdictions across China within 10 years. These proactive prevention and control efforts have been highly evaluated globally.

       The project has independently developed a series of surgical procedures suitable for Chinese patients, which have been included in some international guidelines and specifications and directly save medical expenses by hundreds of millions RMB yuan. The injection of water cushion in the procedure of tension-free vaginal tape (TVT) developed by the research team is effective in treat stress urinary incontinence (SUI) without causing any bladder injury, and the procedure has been adopted by international guidelines. The group also optimized the ischial spinous fascia fixation (ISFF); compared with the traditional suturing of the sacrospinous ligament, the new procedure achieved a cure rate of 94% without any additional expenditure on medical supplies. This technique has been applied nationwide after having been validated in multiple centers across China. The research group also developed the PUMC pelvic floor reconstruction, which uses a carefully designed and cropped mesh, its residual materials, self-designed puncture needle, and an optimized approach for pelvic floor reconstruction; compared with the traditional treatments, the procedure decreases the medical cost by 3/4, with a higher cure rate and fewer complications. It has been applied in more than 100 hospitals across China and in some Southeast Asian countries including Singapore and the Philippines, benefiting more than 10,000 patients.

△ Lang Jinghe (first from left) and Zhu Lan (third from left) performs a pelvic floor reconstruction surgery

The team has carried out in-depth basic research on the pathogenesis of PFD including the morphology and the neuromuscular pathology of pelvic floor supporting tissues, which confirmed the "Hammock Theory" of stress urinary incontinence and solved many challenging, intriguing problems. Their research results have won two international awards, and its findings and conclusions have been included in two international guides.

The project team has successfully developed the first 3D printing material for urinary incontinence with independent intellectual property rights, which broke the international monopoly and has been applied in 15 provinces and municipalities in China and in Europe.

Thanks to the efforts of the research team, the Female Pelvic Floor Disorders Group of the Chinese Society of Obstetrics and Gynecology has been established. So far the Group has developed seven guidelines and clinical pathways (e.g. Guidelines for the Diagnosis and Treatment of Female Stress Urinary Incontinence), held 125 national and regional academic conferences, and trained more than one million doctors. Many talented clinicians have joined their efforts in establishing and developing the subspeciality of urogynecology in China. Dr. Zhu has organized 22 international conferences on urogynecology. Now she is the only member of the editorial board of Urologia Internationalis and the only Chinese representative in the Academic Committee of International Urogynecological Association. She was the main contributor for the revision of the Surgery section of the international guidelines, which fundamentally improved the prevention and control of PFD in China.