Surgery MCQs Q4

FreeMedSite

SURGERY • UROLOGY

A 45-year-old multiparous woman presents with complaints of involuntary leakage of urine, especially during coughing and sneezing. She also reports occasional urgency. Physical examination suggests possible pelvic floor weakness.

Which of the following is the most appropriate investigation to evaluate urinary incontinence in females?

A Colonoscopy

B Cystoscopy

C Cystometry

D Ureteroscopy

E Colposcopy

Cystometry. This is the most appropriate functional investigation (part of urodynamics) to differentiate between stress, urge, and mixed incontinence.

Decoding Clue

1

CLUE "Leakage during coughing/sneezing + Urgency"

TRANS Suggests a mix of Stress (Pelvic floor) and Urge (Detrusor) components.

2

CLUE "Appropriate Investigation"

TRANS Incontinence is a functional problem; thus, we need a functional test (Urodynamics) rather than a visual one.

Differential Breakdown

A. Colonoscopy: Used for bowel pathology, unrelated to bladder dynamics.

B. Cystoscopy: Structural visual exam. Good for spotting tumors or stones, but cannot diagnose stress incontinence.

D. Ureteroscopy: Used for management of ureteric stones; no role in incontinence evaluation.

E. Colposcopy: Gynaecological procedure for cervical evaluation, not urinary leakage.

🧠 Urinary Incontinence Quick-Review

Type	Mechanism	Classic Symptom
Stress	Urethral hypermobility	Leakage on effort/cough
Urge	Detrusor Overactivity	Sudden intense desire to void
Overflow	Detrusor Atony/Obstruction	Continuous dribbling

Integrated Clinical Questions

1. Most common type of urinary incontinence in females?

Answer: Stress incontinence.

2. What is the underlying cause of stress incontinence?

Answer: Pelvic floor weakness or urethral hypermobility.

3. Urge incontinence is primarily due to?

Answer: Detrusor overactivity (involuntary bladder contractions).

4. First-line management of stress incontinence?

Answer: Pelvic floor (Kegel) exercises.

5. Which drug class is used for urge incontinence?

Answer: Antimuscarinics (e.g., oxybutynin, tolterodine) or Beta-3 agonists (e.g., mirabegron).

← Previous Question Next Question →

FreeMedSite • Open Medical Education