Urogynaecology Flashcards
A 65-year-old woman complains of urinary frequency, nocturia and occasional incontinence. She had a hysterectomy for menorrhagia 25 years ago. She is not taking any medications. A midstream urine specimen shows no growth in culture. The problem is getting worse over the last few months and she complains of sometimes wetting herself on her way to the toilets. Choose the most appropriate diagnosis
a) Urinary infection
b) Diabetes mellitus
c) Detrusor instability
d) Stress incontinence
e) Urethritis
c) Detrusor instability
A Para 2, aged 26, at postnatal examination at 6 weeks complains of urinary incontinence on coughing and sneezing. Apart from a little laxity at the introitus there are no abnormal findings. Would you:
a) tell her to complete her family before considering a repair
b) fit her with a ring pessary
c) advise an immediate pelvic floor repair
d) advise pelvic floor muscle training and bladder retraining in the first instance
e) prescribe oestrogen cream for vaginal use
d) advise pelvic floor muscle training and bladder retraining in the first instance
The uterus is supported by the
a) round ligaments
b) broad ligaments
c) cardinal ligaments
d) ovarian ligaments
e) infundibulopelvic ligaments
c) cardinal ligaments
Recognised associations of utero-vaginal prolapse include:
a) multiparity
b) obesity
c) constipation
d) chronic bronchitis
e) all of the above
e) all of the above
Urodynamics
a) Involves filling the bladder with opaque dye
b) Is generally performed under general anaesthetic
c) Should be arranged in the first 10 days after the first day of menstrual period
d) Is able to differentiate genuine stress incontinence from urge incontinence
e) None of the above
d) Is able to differentiate genuine stress incontinence from urge incontinence
Which one of the following is NOT associated with pelvic floor dysfunction?
a) Anorexia
b) Marfans Syndrome
c) Heavy lifting
d) Chronic bronchitis
e) Constipation
a) Anorexia
Which one of the following is NOT associated with the management of detrusor overactivity?
a) Bladder retraining
b) Carbachol
c) Caffeine reduction
d) Local estrogens
e) Sacral neuromodulation
b) Carbachol
Which one of the following is NOT associated with the management of pelvic organ prolapse?
a) Anterior colporrhaphy
b) Myomectomy
c) Ring pessary
d) Sacrocolpopexy
e) Vaginal hysterectomy
b) Myomectomy
Which one of the following is NOT true regarding the management of urodynamic stress incontinence?
a) Pelvic floor muscle training gives up to 6% improvement
b) Self-fixing vaginal slings result in up to 85% cure/improvement
c) Colposuspension suspends the vaginal fornices to the iliopectineal ligaments
d) Tension-free vaginal tape sling, colposuspension and injectables all have a similar success rate for treating incontinence
e) Denovo detrusor overactivity can complicate up to 5-10% of incontinence correcting surgery
d) Tension-free vaginal tape sling, colposuspension and injectables all have a similar success rate for treating incontinence
Which one of the following statements is true regarding urodynamics?
a) Involves filling the bladder with opaque dye
b) Is able to diagnose detrusor overactivity, urodynamic stress incontinence and voiding dysfunction
c) Should be arranged in the first 10 days after the first day of menstrual period
d) Is generally performed under general anaesthetic
e) None of the above
b) Is able to diagnose detrusor overactivity, urodynamic stress incontinence and voiding dysfunction
Which one of the following is NOT true regarding oxybutynin and detrusor overactivity?
a) Is an alpha adrenergic agonist.
b) Results in up to a 60 percent improvement.
c) Has dry mouth and blurring of vision as side effects.
d) Is contraindicated by some types of glaucoma.
e) Is publicly funded for detrusor overactivity
a) Is an alpha adrenergic agonist.
Which one of the following is NOT true regarding TVT for surgery for urodynamic stress incontinence?
a) Results in 5 % de novo urgency.
b) Results in 3% voiding dysfunction.
c) Results in 5-10% prolene mesh exposure.
d) Is the current “gold standard” for surgery for this condition.
e) Results in a 80% symptomatic improvement after 17 years of use.
c) Results in 5-10% prolene mesh exposure.
Which of the following symptoms do not relate to pelvic organ prolapse?
a) Chronic vaginal discharge
b) Feeling of a lump in the vagina or outside the vagina
c) A slow urinary stream
d) A feeling of incomplete emptying of the bladder
e) Heavy dragging sensation in the vagina of lower back
a) Chronic vaginal discharge
