EBCOG Part -1 Urogyenacology Day- 3(S.B.A)

1.A 39-year-old patient presents with symptoms of leakage of urine upon coughing, sneezing and during exercise. The symptoms started following the birth of her second child 18 months ago. What would be the first line of management?

A. Biofeedback/Electrical stimulation
B. Bladder retraining
C. Insertion of a midurethral retropubic tape
D. Pharmacotherapy with Duloxetine
E. Supervised Pelvic floor muscle training

2.A39-year-oldpara1patientpresentswithstressincontinencewith no other urinary symptoms.What would be the first line of management?

A. A trial of pelvic floor muscle training for at least 3 months
B. Electric stimulation in combination with pelvic floor muscle training
C. Pelvic floor electromyography (biofeedback)
D. Pelvic floor muscle training that involves 6 contractions done every 3 days for 6 months
E. Urodynamic studies

3.A 38-year-old patient is suffering with stress incontinence. Her BMI is 32 kg/m2 and the patient is interested in lifestyle manage- ment for her incontinence.What is the most important lifestyle change that you would recommend?

A. Avoidance of caffeinated drinks
B. Exercise
C. Reduction of alcohol intake
D. Reduction of fluid intake
E. Weight loss

4. A 38-year-old patient is suffering with symptoms of an overactive bladder. Her BMI is 25 kg/m2 and the patient is interested in lifestyle changes.What is the most important lifestyle change that you would recommend?

A. Avoidance of caffeinated drinks
B. Exercise
C. Reduction of alcohol intake
D. Reduction of fluid intake
E. Weight loss

5. An 84-year-old patient presents with symptoms of urgency, urgency incontinence and nocturia. The patient is taking several different medications for other medical conditions. A diagnosis of overactive bladder is made.The general practitioner has already tried Oxybutynin but the patient had side effects (central nervous system) and this was stopped.
Which anticholinergic medication would you now consider?

A. Darifenacin
B. Fesotrodine
C. Solifenacin
D. Tolterodine
E. Trospium chloride

6. A 52-year-old patient presents with a history suggestive of an overactive bladder, but also complains of fecal incontinence.The patient has tried conservative measures and various anticholinergics with no significant benefit.Urodynamic testing confirms detrusor overactivity and some void- ing dysfunction.What is the best surgical option for this patient?

A. Augmentation cystoplasty
B. Botulinum toxin injections to the bladder and teaching the patient intermittent self-catheterisation
C. Intravesical therapy (Oxybutynin)
D. Posterior tibial nerve stimulation
E. Sacral neuromodulation

7.Ms. Roberts is 55 years old. She suffers from symptoms of an overactive bladder. Bladder retraining has not helped her. Her recent urine analysis is negative for infection.What is next step in her management?

A. Botulinum A toxin
B. Mirabegron
C. Darifenacin once daily
D. Transcutaneous posterior tibial nerve stimulation
E. Urodynamic studies

8. A 60-year-old woman attends the urogynaecology clinic with urinary incontinence associated with coughing and sneezing. A urine dipstick is negative.A diagnosis of stress urinary incontinence is made.What would be considered the first-line treatment?

A. Bladder training
B. Desmopressin
C. Duloxetine
D. Systemic hormone replacement therapy (HRT)
E. Supervised pelvic floor muscle training

9. A fit and healthy 52-year-old patient with confirmed detru- sor overactivity has tried three different medical treatments (Oxybutynin, Solifenacin, Mirabegron).The procedure that should be offered to the patient is

A. Botulinum toxin A injections into the bladder
B. Detrusor myomectomy
C. Percutaneous tibial nerve stimulation
D. Sacral nerve modulation
E. Urinary diversion

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