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OBG · Benign gynaecology: vesicovaginal fistula
Sample itemContinuous leakage of urine per vagina after prolonged obstructed labour is most likely due to:
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Vesicovaginal fistula from pressure necrosis
Pressure necrosis of the bladder and vaginal wall in obstructed labour causes vesicovaginal fistula. The three-swab (methylene blue) test confirms the diagnosis. Repair is done after about 3 months, or earlier in a fresh clean fistula, with catheter drainage.
Option by option
A. Stress incontinence
Stress incontinence occurs only with exertion.
B. Overflow incontinence
Overflow incontinence follows retention.
C. Vesicovaginal fistula from pressure necrosis (correct)
Correct. This is the classic obstetric fistula.
D. Urge incontinence
Urge incontinence is intermittent.
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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