Clinical Expert Series
Diagnosis and Surgical Treatment of Stress Urinary Incontinence
Alan D. Garely, MD, and Nabila Noor, MD
Obstet Gynecol 2014;124(5)
Continuing Medical Education credit is provided through joint sponsorship with
The American College of Obstetricians and Gynecologists.
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Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
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Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits™ to be
equivalent to College Cognate Credits.
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control of any commercial interest. All authors, reviewers, and contributors have disclosed to the College all relevant financial
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Submission
Before submitting this form, please print a completed copy as confirmation of your program participation.
College Fellows: To obtain credits, complete and return this form by e-mail (obgyn@greenjournal.org) or fax (202-479-0830).
Your score, and a copy of the answer key, will be e-mailed to you after receipt of a completed quiz. Credit will be recorded for
those participants answering 80–100% of questions correctly. College Fellows may check their transcripts online at
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please contact the Obstetrics & Gynecology Editorial Office, 202-314-2317 (phone) or obgyn@greenjournal.org (e-mail).
Non–College Fellows: To obtain credits, submit the printout of the completed quiz to your accrediting institution. The printout of
the completed quiz is documentation for your continuing medical education credits.
Continuing medical education credit for “Diagnosis and Surgical Treatment of Stress Urinary Incontinence” will be available
through November 2017.
1. Surgical therapy for stress urinary incontinence has proven superiority over medical therapy due to:
Improved reimbursement
Better long-term improvement
Reduced long-term morbidity
Associated increased longevity
More rapid resolution of symptoms
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;124(5)
Credit available through November 2017
Page 1 of 3
2. Which of the following should be considered first-line surgical therapy for stress urinary
incontinence?
Urethral dilation
Retropubic urethropexy
Electronic bladder stimulation
Urethral bulking agents
Artificial sphincter
3. The most common form of urinary incontinence is:
Stress incontinence
Urge incontinence
Mixed incontinence
Overflow incontinence
Bypass incontinence
4. Stress incontinence occurs when intra-abdominal pressure:
Is greater than 15 mm Hg
Is unequally transmitted to the bladder and the urethra
Provokes a contraction of the detrusor musculature
Results in a drop in vaginal and urethral pressures
Is unopposed by the levator plate musculature
5. The best reason to use a questionnaire to evaluate symptoms of urinary incontinence is to:
Establish a diagnosis
Correlate a patient’s symptoms to their quality of life
Obviate the need for clinical testing
Establish baseline symptoms to assess the effects of therapy
Document the indication for surgery
6. The “gold standard” for the diagnosis or evaluation of stress urinary incontinence is:
The 3 Incontinence Questions (3IQ)
The International Consultation on Incontinence Questionnaire (ICIQ)
The Bristol Female Lower Urinary Tract Symptoms Scored Form (BFLUTS-SF)
The Norwegian Stress and Urge Incontinence Questionnaire (SUIQQ)
Urodynamics testing
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;124(5)
Credit available through November 2017
Page 2 of 3
7. An office cystometric study is terminated after the bladder has been filled with 500 mL of saline due
to patient discomfort and the inability to tolerate any further distension. This establishes:
First sensation
Maximum cystometric capacity
A diagnosis of interstitial cystitis
A diagnosis of urge incontinence
Bladder detrusor irritability
8. The National Institute for Health and Care Excellence Guidelines suggest that a patient with stress
urinary incontinence who desires surgical management should be offered a(n):
Anterior colporrhaphy
Needle suspension
Paravaginal repair
Laparoscopic urethropexy
Midurethral sling
9. The most common complication related to mesh slings is:
Mesh erosion
Pain
Infection
Recurrent incontinence
Pain during sexual intercourse
10. Sutures placed through Cooper’s ligament to provide support for the urethra defines the:
Marshal Marchetti Krantz procedure
Burch procedure
Tension-Free Vaginal Tape (TVT) sling
Transobturator Tension-Free Vaginal Tape (TVT-O) sling
Autologous rectus facial sling
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CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;124(5)
Credit available through November 2017
Page 3 of 3