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EAU, Chapter 5 MCQs
EAU · MBBS / Medicine · 24 practice questions
- Men with SUI - surgical options
- Refractory detrusor overactivity - escalation pathway
- Mixed urinary incontinence surgical outcomes
- Refractory detrusor overactivity - surgical options
- Neuromodulation - percutaneous tibial nerve stimulation
- Desmopressin monitoring
- Pooled recommendations - desmopressin and antimuscarinic cautions
- Surgical management principles for uncomplicated SUI
1. A 62-year-old woman with urgency urinary incontinence has been treated with an antimuscarinic for six months with no benefit. She declines dose escalation or mirabegron. Which of the following is an appropriate next option specifically supported for this exact clinical scenario?
- AElectrical stimulation with surface electrodes alone
- BPercutaneous tibial nerve stimulation
- CMagnetic stimulation for overactive bladder
- DImmediate augmentation cystoplasty
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B. Percutaneous tibial nerve stimulation PTNS is specifically recommended for UUI in women not benefiting from antimuscarinic medication; magnetic stimulation should not be offered for UI/OAB in women; surface electrode stimulation alone is not recommended for SUI; augmentation cystoplasty is reserved for failure of all other treatments, not as an early next step.
2. A 40-year-old woman with urgency urinary incontinence refractory to pelvic floor muscle training and antimuscarinic therapy is being counselled about intravesical botulinum toxin A injection. Which specific risk must she be explicitly warned about, including ensuring her willingness and ability to manage it?
- AImmediate need for urinary diversion within one month
- BGuaranteed permanent cure without need for retreatment
- CPossible prolonged need to self-catheterise
- DPermanent loss of bladder sensation
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C. Possible prolonged need to self-catheterise Patients must be warned of the limited duration of response, risk of urinary tract infection, and possible prolonged need to self-catheterise, ensuring they are willing and able to do so; the other options are not supported and misrepresent the described risks and outcomes.
3. A 70-year-old woman with urgency urinary incontinence is started on an antimuscarinic after failing conservative therapy but reports dry mouth interfering with adherence. Which of the following represents the most appropriate strategy to improve tolerability while still targeting efficacy?
- AAdd desmopressin for long-term control
- BSwitch to an extended-release formulation
- CDiscontinue antimuscarinic therapy permanently and offer no alternative
- DImmediately proceed to bladder wall botulinum toxin injection
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B. Switch to an extended-release formulation The guidance recommends considering extended-release formulations whenever possible for tolerability; desmopressin is not for long-term UI control; permanent discontinuation without an alternative is not consistent with recommendations for dose escalation, alternative formulation, or mirabegron; botulinum toxin is reserved for refractory cases after conservative and drug treatment fail, not as an immediate substitute for tolerability issues.
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