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General Surgery · Urology: surgery for stress urinary incontinence
Sample itemA 48-year-old woman leaks urine only on coughing and lifting. Urodynamics show urethral hypermobility with no detrusor overactivity, and pelvic floor exercises have failed. Which operation is most appropriate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Mid-urethral synthetic tape sling
Stress incontinence from a weak urethral support is treated by a mid-urethral tape that supports the urethra during rises in abdominal pressure. Botulinum toxin, neuromodulation and augmentation cystoplasty are for refractory detrusor overactivity.
Option by option
A. Augmentation cystoplasty
Augmentation cystoplasty enlarges a small overactive bladder and does not treat sphincter weakness.
B. Sacral nerve neuromodulation
Neuromodulation treats urgency and retention, not stress leakage.
C. Mid-urethral synthetic tape sling (correct)
Correct. A mid-urethral tape restores urethral support during effort.
D. Intradetrusor botulinum toxin injection
Botulinum toxin treats detrusor overactivity by reducing contractions.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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