Urinary Continence

Option List:
A. Pelvic floor muscle training
B. Pessaries
C. Abdominal Sacrocolpopexy
D. Laparoscopic Sacrocolpopexy
E. McCall Culdoplasty
F. Sacrospinous fixation
G. Colposuspension
H. Autologous rectal fascial sling
I. Mid-urethral tape procedures
J. Colpocleisis

1. While performing a vaginal hysterectomy for a 65-year-old woman for a POP, the vaginal vault was found to be at the introitus?

2. 49-year-old woman undergoing vaginal hysterectomy for uterovaginal prolapse, she was told about the recurrence of vault prolapse. She wishes to have a procedure which will prevent PHVP?

3. 56-year-old woman underwent vaginal hysterectomy for POP 5 years back. Now she has distressing vaginal vault prolapse. She wishes to have a surgery with an earlier recovery and that does not affect her sexual function?

4. 53-year-old woman underwent a vaginal hysterectomy, she is now again symptomatic with vault prolapse. She wishes to have a surgery but is worried that she might have SUI following the surgery for vault prolapse?

5. 84-year-old lady has been on pessaries for Pelvic organ prolapse. She had been using pessaries for more than 5 years. She has been suffering from bleeding per vaginam, ulceration and intractable pain and discomfort. She wishes to have a definitive treatment?

6. 78-year-old woman with multiple co-morbidities has stage 4 prolapse. The best treatment option is?

Option List:
A. Oxybutynin
B. Tolterodine
C. Darifenacin
D. Mirabegron
E. Transdermal oxybutynin
F. Desmopressin
G. Vaginal estrogen
H. Oral HRT
I. Duloxetine
J. Imipramine

7. 46-year-old woman with symptoms of urgency, frequency, and distressing nocturia. The drug of choice is?

8. 61-year-old woman with symptoms of OAB has tried bladder training, Oxybutynin, tolterodine, and even darifenacin. She is reluctant for invasive procedures. She would wish to try medications.

9. 65-year-old woman with urge incontinence, has tried bladder training for more than 6 weeks. Now wants to try a treatment that she would benefit from. She wishes to avoid surgery. The management of choice is?

10. 80-year-old woman frail woman distressed with OAB failed first line management. What is the best drug that can be given?

11. 59-year-old woman who is a known uncontrolled hypertensive is unable to tolerate the symptoms of oxybutynin, tolterodine, darifenacin. What is the next best drug?

12. 56-year-old post-menopausal woman with overactive bladder symptoms on examination found to have vaginal atrophy and erosion of the vagina. The best medication is?