Siebel Scholar Pamela Duran : understanding and preventing pelvic floor muscle dysfunction

 By: Kiran Kumar

Pamela Duran

UC San Diego bioengineering PhD student Pamela Duran recently received an award for best doctoral basic science research from the American Urogynecologic Society (AUGS) for her research on how repeated birth injuries impact the pelvic floor muscles.  

Duran, who is co-advised by bioengineering professor Karen Christman and Dr. Marianna Alperin, associate professor of obstetrics, gynecology, and reproductive sciences, is also a Siebel Scholar. 

“Pelvic floor disorders can develop later in life,” said Duran. “Years after giving birth I could see how women are really affected by these conditions. It really impacts their quality of life and I think in general, there needs to be more research into biomaterials to treat these conditions.”

 Nearly one fourth of women will experience pelvic floor disorders, making it one of the most significant women’s health issues. Some of the symptoms of these disorders include frequent urination, leaking stool or urine, constipation, descension of pelvic organs, and pain/pressure in the pelvic region and/or lower back, which can heavily impact an individual's quality of life. 

During her PhD, Duran has done research to better understand how one or repeated birth injuries impact the regenerative abilities of the pelvic floor tissue. Using an animal model, she found that after a birth injury, the pelvic floor muscle undergoes sustained inflammation, impairment in muscle anabolism and persistent extracellular matrix remodeling, leading to long-term muscle atrophy and fibrosis. Understanding the mechanisms that impact pelvic floor tissue repair will help researchers and clinicians develop treatments for faster and more effective healing. 

In addition to studying how birth injuries impact pelvic floor muscle regeneration, Duran has also done research on injectable biomaterials to help prevent pelvic floor dysfunction. She analyzed the efficacy of a minimally invasive therapy to treat the pathological alterations of the pelvic floor muscle. She injected a skeletal muscle-derived extracellular matrix hydrogel at two different therapeutic windows--either at the time of birth injury or at a delayed time point. In both studies, the biomaterial prevented pelvic floor muscle atrophy and mitigated fibrosis through modulation of immune response, augmentation of muscle regeneration pathway and native extracellular matrix remodeling. Duran is currently investigating the efficacy of the hydrogel after multiple birth injuries. 

 “Women think that if they are uncomfortable or if they got injured during childbirth that it is common; but it is not something to be ignored. This can, in the future, lead to pelvic floor disorders.”

 Though women sometimes downplay discomfort in the pelvic region after childbirth, Duran encourages women to treat these disorders as seriously as they would any other health issue. While they do, Duran and other researchers at the school will continue to spearhead cutting-edge research in this crucial women’s health area.