EBCOG Part 1 Urogyneacology Day 2 (SBA)

1. Mrs. Green’s urodynamic results are as follows. She has initial residual volume of 90 ml and 1st desire to void at 140 ml. Her maximum capacity is 380 ml. During filling phase, systolic detrusor activity is seen which increased with tap water but not with cough in supine position. She did leak a little urine during repeated coughing in the erect posture. She had a Keilland forceps delivery 10 years ago and since then has urinary leakage on standing and straining mostly. She also wakes up at night a few times to go to the toilet. What is the likely diagnosis?

2. A 37 year old woman who had 4 vaginal deliveries out of which 1 was a difficult forceps delivery followed by a 3rd degree perineal tear. She presents for the first time with symptoms of stress urinary incontinence and on clinical examination incontinence is demonstrated on coughing.What would be the choice of investigation/ test on her first visit?

3. A 35-year-old woman presents to urogynaecology clinic with predominantly urinary symptoms. cystoscopy should be booked if

4) What is the diagnosis, looking at the urodynamic study picture?

5. During investigation of lower urinary tract symptoms, videourodynamics would be preferred to conventional urodynamics in which of the following scenarios?

6. During investigation of lower urinary tract symptoms, videourodynamics would be preferred to conventional urodynamics in which of the following scenarios?

7. A 56-year-old woman undergoes urodynamic assessment. During the test, there is no change to detrusor activity; however, she experiences urinary leaking on coughing. The diagnosis is therefore most likely to be:

8. A 55-year-old woman attends the urogynaecology clinic with urinary incontinence associated with urgency. A urine dipstick is negative. A diagnosis of urgency urinary incontinence is made. What would be considered the first-line treatment?

9. 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?

10. Which antimuscarinic drug used in the management of an overactive bladder should be avoided in frail older women?