PROJECT SUMMARY The purpose of this proposal is to demonstrate the capabilities of the University of Pittsburgh to participate as a clinical site in the NICHD-sponsored Pelvic Floor Disorders Network (PFDN). Our site has a longstanding track record of successful contribution to multicenter studies of urinary and fecal incontinence, and pelvic organ prolapse. We are particularly well suited to be a clinical site in the PFDN because of our volume, research infrastructure and track record, basic and translational experience and expertise. Access to large numbers of nulliparous women enables us to contribute uniquely to studies of the role of pregnancy and parturition in the etiology and prevention of pelvic floor disorders (PFDs). Magee-Womens Hospital (MWH) is the central resource for gynecologic specialty care for the 19 hospital University of Pittsburgh Health System serving a very large aging population. Our site brings expertise in urogynecology, physical therapy, urology, gastroenterology, geriatrics, and biomechanical engineering. We offer unique technical expertise in development of finite element models of the vagina and its supportive tissues after surgery, biochemical and biomechanical impact of meshes on the vagina, dynamic 3D MRI and transperineal ultrasound of the pelvic floor, tissue regenerative techniques, genomics, proteomics, and central neuronal control of bladder function. In this application we describe: 1. our experience and productivity in multicenter randomized trials and clinical trials networks, our available population for enrollment and the clinical expertise of investigators; 2. special strengths of our transdisciplinary translational investigators; 3. our research personnel staffing and management plan for recruitment and retention of subjects in PFDN trials.