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Knowledge Area 15 – Urogynaecology and pelvic floor problems

Capability in practice (CiP)

  • 1: The doctor is able to apply medical knowledge, clinical skills and professional values for the provision of high-quality and safe patient-centred care
  • 6: The doctor takes an active role in helping self and others to develop
  • 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy care

 

Summary Knowledge Requirements

PART 1 MRCOG

  • Structure of the bladder and pelvic floor and their innervation
  • Mechanisms of continence and micturition and principles of pelvic floor support
  • How congenital anomalies, pregnancy and childbirth, disease, infection and estrogen deficiency affect these mechanisms
  • Principles underlying the treatment of bladder and pelvic floor problems and the impact of other drugs on bladder function

PART 2 MRCOG

  • Understand the management of urinary and faecal incontinence, benign bladder conditions and urogenital prolapse
  • Demonstrate an understanding of the anatomy, pathophysiology, epidemiology, aetiology and investigation of these conditions

PART 3 MRCOG

  • Understand the management of urinary and faecal incontinence, benign bladder conditions and urogenital prolapse
  • Demonstrate an understanding of the anatomy, pathophysiology, epidemiology, aetiology and investigation of these conditions
  • Know when more experienced help is required in the management of your patients
  • Be able to discuss clearly all aspects of management with patients, carers and other continence care providers

 

Detailed Knowledge Requirements

  • Anatomy, physiology and pathophysiology of: pelvic Floor, urinary tract
  • Epidemiology, aetiology, characteristics and prognosis of: urinary and faecal incontinence, urogenital prolapse, urinary infection, lower urinary tract disorders, urinary disorders associated with other conditions
  • Indications and limitations of Investigations: microbiological examination of urine, quantification of urine loss, urodynamic investigations, videocystourethrography, urethrocystoscopy, imaging
  • Indications, techniques, limitations and complications of non-surgical treatment: Pads and garments, Bladder retraining, Pelvic floor exercises, Self-catheterisation, Long-term indwelling catheterisation, Community care
  • Indications, techniques, limitations and complications of drug treatment: Anticholinergics, Anti-muscarinic, Alpha blockers, Antidepressants, Oestrogens
  • Indications, techniques, limitations and complications of surgical treatment: Urethral dilatation, Urethrocystoscopy, Suprapubic catheterisation, Peri-urethral injectables, Anterior repair, Vaginal hysterectomy, Vaginal repair of genital tract prolapse, Sling procedures, Colposuspension, Repair of recurrent prolapse, Fistula repair, Urinary diversion, Injectables
  • Epidemiology, aetiology, characteristics and prognosis of Urinary and faecal incontinence: Urodynamic Stress incontinence, Detrusor over activity, Voiding disorders and urinary retention, Urinary frequency and urgency
  • Epidemiology, aetiology, characteristics and prognosis of Lower urinary tract disorders: Urethral disorders, Pain, Fistulae, Effects of radical pelvic surgery, Effects of irradiation
  • Epidemiology, aetiology, characteristics and prognosis of Urinary disorders associated with other conditions: Pregnancy, Gynaecological pathology, Elderly patients, Neurological conditions
  • Indications and limitations of Urodynamic investigations: Voiding charts, Ambulatory monitoring, Urodynamic equipment, Uroflowmetry, Standard subtracted cystometry
  • Indications and limitations of Imaging: Upper urinary tract, Lower urinary tract, Pelvic floor