Respected Dr Paul
Sorry to disturb you ,plz can I know ,in theses emcq the answer why given
like this ,plz I want to correct myself I am not under standing them ,I
will be thankful if I get the answer .
Liza
Options for Questions 10-10
A Shelf pessery B Abdominal sacro-colpopexy
C Sacro-spinous fixation D Anterior colporrhaphy with mesh from rectus
sheath
E Anterior colporrhaphy with absorbable synthetic mesh F Anterior
colporrhaphy with combination of absorbable and non-absorbable mesh
G Anterior colporrhaphy with non-absorbable Type I mesh H Anterior
colporrhaphy with non-absorbable Type II mesh
I Anterior colporrhaphy with non-absorbable Type III mesh J Anterior
colporrhaphy with non-absorbable Type IV mesh
K Colposuspension L Tension-free vaginal tape
M Trans-obturator tape N Laparoscopic sacro-colpopexy
Instructions:For each scenario described below, choose the single most
appropriate management from the above list of options. Each option may be
used once, more than once, or not at all.
Explanation
Question 10 A healthy 67 year old woman attends the gynaecology clinic
with 6 months history of feeling a lump in the vagina but no other
symptoms. She experienced similar symptoms 4 years earlier and was cured
by anterior colporrhaphy. On examination, there is a stage 3 anterior
vaginal wall prolapse with no evidence of stress urinary incontinence.
Why the answer is G Why not L
She already had anterior colporraphy ,again she has to have anterior
colporraphy with type 1 mash
Options for Questions 11-11
A Risk of bladder injury B Risk of bleeding
C Risk of infection D Risk of venous thromboembolism
E Risk of mesh migration F Risk of rectal injury
G Risk of recurrent prolapse H Risk of posterior vaginal prolapse
I Risk of urinary incontinence J Risk of urethral injury
K Risk of ureteric injury L Risk of vaginal dryness
Instructions:For each scenario described below, choose the single most
important risk that should be discussed from the above list of options.
Each option may be used once, more than once, or not at all.
Explanation
Question 11 A 45 year old woman with a 6 months history of a vaginal lump
is found to have a stage III anterior vaginal prolapse. Her BMI is 37. She
is due to undergo anterior vaginal wall repair using Type I mesh.
We have to discuss most common risk here why mesh migration which a rare
complication
Posted by Farrukh G.
1) Why do TVT when the question clearly says there is no urinary incontinence? TVT is not an operation to treat anterior vaginal wall prolapse.
2) Question asked about most important, not most common.