EBCOG P1 – 3 Month – Urogynaecology – Pelvic organ prolapse – Day 2

1.The nerve that is susceptible to entrapment injuries during sacrospinous ligament fixation as it runs behind the lateral aspect of the sacrospinous ligament is the:

2.The main complication of mesh repair in vaginal prolapse:

3.Vault prolapse can be prevented at the time of vaginal hysterectomy by:

4.Ms. XY is 70 years old. She presents to the urogynaecology specialist nurse with the  complaint to feeling a bulge per vaginum. She has had a TAH +BSO 15 years ago.   Which point corresponds to the vaginal vault/cuff scar on the POP –Q (pelvic  organ prolapse quantifi cation system)?

5.Ms. XY is 70 years old. She presents to the urogynaecology specialist nurse with the  complaint of feeling a bulge per vaginam. She has had a TAH + BSO 15 years ago.   Which of the following points on the POP-Q system will not be recorded as a  part of her assessment?

6.All of the following statements regarding anterior wall repair are true except

7.Which of the following is not an example of a problem arising from pelvic fl oor  dysfunction?

8.A 57-year-old, post menopausal woman complains of ‘something coming out of her  vagina’ and diffi culty in opening her bowels. She had four children uneventfully  with vaginal births. Her last child birth was 18 years back. The most likely diagnosis  is:

9.An 84-year-old patient who had a previous history of vaginal hys terectomy presents with a stage 3 vault prolapse. The patient has limited mobility and has previously had difficulty with the use of vaginal pessaries. What is the most appropriate treatment option?

10.A 56-year-old para 4 woman presents with a vault prolapse. The patient is sexually active and urodynamic investigations fail to reveal urodynamic stress incontinence even after reduction of the prolapse. The patient is keen on having surgery. Which of the following operations should be offered?

11.patient is undergoing a vaginal hysterectomy for uterine pro lapse and at the end of the procedure it is noted that the vault of the vagina descends to 3 cm above the hymenal ring. What should be considered in order to prevent further descent of the vault in the future?

12.A patient presents with symptoms of a prolapse. On examination, the pelvic organ quantification score is Aa 0, Ba 0, C −5, D −7, Ap −2 Bp −2 tvl 9, gh 4, pb 3. The patient wants her prolapse to be treated surgically. What is the correct diagnosis and surgical treatment?

13.A woman presents with symptoms of a prolapse. On examination, the pelvic organ quantification score is Aa −2, Ba −2, C −5, D −7, Ap 0 Bp 0 tvl 9, gh 4, pb 3 The patient wants her prolapse to be treated surgically. What is the correct diagnosis and surgical treatment?

14 .A 48-year-old morbidly obese woman has a sister who recently had surgical treatment for prolapse. She is therefore interested in finding more about the impact of obesity on the development of prolapse. The occurrence of which type of prolapse shows the most significant increase in association with morbid obesity?

15.woman is contemplating having either a Sacrospinouscolpopexy (no mesh) or a Sacrocolpopexy (with mesh). The patient is keen on having a Sacrocolpopexy but is concerned about novo prolapse. What is the incidence of de novo prolapse (cystocele), after Sacrocolpopexy and Sacrospinouscolpopexy?