This page is dedicated to organizing various examples of standardized exam questions whose answer is urethrocele. While this may seem a odd practice, it is useful to see multiple examples of how urethrocele will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 51 year old woman, gravid 4, para 3, aborta 1, complains of urinary incontinence when coughing, straining, or lifting objects. This all began about 10 years ago after the birth of her last child. She explains that her symptoms have worsened over the past 2 years. During the pelvic exam she loses urine in small amounts when coughing. The physician notes that the anterior and posterior vaginal walls appear to be well supported. A cotton swab is placed in the urethra, and moves in an arch of 45 degrees (relative to the horizontal) when the patient conducts the Valsalva maneuver. What is the most likely diagnosis?
Question # 2
A 51 year old woman G4P3 aborta 1 notices a loss of urine when coughing, laughing, or straining herself when lifting objects. She first began noticing these symptoms after the birth of her last child 10 years ago. She explains that the symptoms have worsened over the past 2 years. During the physical exam there is a small loss of urine when coughing. The anterior and posterior walls of the vagina seem to be well supported. A cotton tipped applicator is placed in the urethra and it moves in an arch of 45 degrees (relative to the horizontal plane) when the patient conducts the Valsalva maneuver). What is the likely diagnosis?
Explanation: stress inconctiennce + urethral hypermobility = urethrocele
Page Updated: 09.29.2016