Gene may predispose women to pelvic disorders

For women who hope to avoid the urinary incontinence or pelvic floor prolapse that are believed to be a part of normal aging, researchers at the University of Utah have some good news: If your female family members don't have it, you might avoid it as well.

A study published this week in the American Journal of Human Genetics is only the second to find a possible genetic link that may predispose women to those kinds of pelvic floor disorders, according to one of the researchers.

Kristina Allen-Brady, an epidemiologist at the U. School of Medicine, said she hopes the study will ease worries for some women, who believe such disorders are simply unavoidable with aging because they are so common. About one-third of U.S. women are affected by a pelvic floor disorder at some point, and one in nine will undergo surgery at least once.

Pelvic floor disorders involve a network of muscles, ligaments and connective tissue that keep all of a woman's pelvic organs in place, and the disorders occur when these tissues weaken or are injured.

The study found significant evidence for a gene that predisposes women to such disorders on chromosome 9.

If that genetic link is eventually proved, "this becomes a disease rather than a normal part of aging," Allen-Brady said. "Maybe in the future we will be able to identify women who are predisposed to this early enough" to help prevent it or treat it early, she said.

The study analyzed DNA from 70 women in 32 different families with at least two cases of pelvic floor disorder (PFD) in each family. The only other study looking at a genetic link was published in 2007 and involved one family, Allen-Brady said.

In the past, the No. 1 risk factor for such disorders was childbirth and the damage that can occur in pelvic tissue during a vaginal delivery, she said. Other risk factors believed to contribute include smoking, obesity and aging.

"Previous research has found that women with urinary incontinence are more likely to have family members with incontinence, but the genetic factors that predispose to PFD are not well understood," Allen-Brady said.

Study participants were originally culled from among women who had surgery at the U. during the past decade for some type of PFD. Those were then narrowed to find women who had at least one sister with a similar disorder who had also had corrective surgery.

Study participants were examined by a doctor and a blood test was taken to gather the DNA, which was then analyzed by researchers looking or a genetic link.

"We haven't found a gene; we've only found a region," where it may eventually be found, she said. "If we could find a gene, we could screen a woman early in life, before she gives birth. If they have a high risk for PFD, they may be counseled to consider a C-section rather than a vaginal birth."

Researchers are in the process of collecting and analyzing DNA from other families that seem to be at a high risk to help strengthen their conclusions.

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