Gynaecological endocrinology: genital fistula: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological endocrinology: genital fistula

Sample item

After prolonged obstructed labour, a woman has continuous leakage of urine. A tampon test with methylene blue instilled in the bladder stains the upper tampon blue. What does this show?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Vesicovaginal fistula

In the three-swab test, dye instilled in the bladder colours the uppermost swab if it leaks through a vesicovaginal fistula. A wet but undyed swab suggests a ureterovaginal fistula. Stress incontinence does not show blue staining of vaginal swabs.

Option by option

  • A. Stress urinary incontinence

    Stress incontinence leaks only on effort and is not continuous.

  • B. Ureterovaginal fistula

    A ureteric fistula would produce wet but unstained swabs.

  • C. Urethral diverticulum

    A diverticulum causes post-micturition dribbling, not dye staining of the swab.

  • D. Vesicovaginal fistula (correct)

    Correct. Dye from the bladder reaching the vaginal swab proves a bladder-vagina communication.

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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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Vesicovaginal fistula. In the three-swab test, dye instilled in the bladder colours the uppermost swab if it leaks through a vesicovaginal fistula.

Why is "Stress urinary incontinence" not the answer?

Stress incontinence leaks only on effort and is not continuous.

Why is "Ureterovaginal fistula" not the answer?

A ureteric fistula would produce wet but unstained swabs.

Why is "Urethral diverticulum" not the answer?

A diverticulum causes post-micturition dribbling, not dye staining of the swab.

What concept does this question test?

It tests Gynaecological endocrinology: genital fistula in OBG. A wet but undyed swab suggests a ureterovaginal fistula. Stress incontinence does not show blue staining of vaginal swabs.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological endocrinology: genital fistula?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.