Urogynae

Question 1

The muscles of the levator ani complex are the

a. Puborectalis, ischiococcygeus, pubococcygeus
b. Bulbocavernosus, superficial transverse perinei, ischiocavernosus, bulbospongiosus
c. Puborectalis, pubococcygeus, iliococcygeus
d. Pubococcygeus, iliococcygeus, pubovaginalis

Answer 1

c. Puborectalis, pubococcygeus, iliococcygeus

Question 2

A 50 year old woman is presents with an everted vaginal 12 years after vaginal hysterectomy. She s sexually active. The PREFERRED treatment would be

a. Control of the prolapse with a pessary
b. Posterior colpoperineorrhaphy
c. Sacrospinous colpopexy or similar procedure
d. Colpocleisis

Answer 2

c. Sacrospinous colpopexy or similar procedure

Question 3

In a nulliparous woman without evidence of prolapse, in the upright anatomical position the normal vaginal axis is

a. Upward and backward at 135 degrees
b. Upward and backward at 230 degrees
c. Upward and backward at 310 degrees
d. Upward and backward at 90 degrees

Answer 3

a. Upward and backward at 135 degrees

Question 4

The lifetime risk of having an operation for genital prolapse is

a. 1 in 5
b. 1 in 9
c. 1 in 20
d. 1 in 35

Answer 4

b. 1 in 9

Question 5

During the performance of a routine abdominal sacrocolpopexy procedure on a woman with a large recurrent enterocele and rectocele, which of the following is MOST CORRECT

a. The most appropriate mesh is a Type 3 polyglactin mesh (multifilament, microporous)
b. The upper end of the mesh should be attached between S1 and S3 at more than one point
c. The procedure should generally include perineorrhaphy
d. The procedure should be supported by a Muscowitz operation

Answer 5

b. The upper end of the mesh should be attached between S1 and S3 at more than one point