Pelvic floor dysfunction include all of the following EXCEPT:
Pelvic floor disorders can be categorized, from an urogynecologic perspective, into three main topics: female urinary incontinence and voiding dysfunction, pelvic organ prolapse, and disorders of defecation.
All of the following are true concerning stress incontinence EXCEPT:
Stress incontinence is believed to be caused by lack of urethrovaginal support (urethral hypermobility) or intrinsic sphincter deficiency (ISD). ISD is a term applied to a subset of stress-incontinent patients who have particularly severe symptoms, including urine leakage with minimal exertion. This condition is often recognized clinically as the low pressure or "drainpipe" urethra. The urethral sphincter mechanism in these patients is severely damaged, limiting coaptation of the urethra. Standard surgical procedures used to correct stress incontinence share a common feature: partial urethral obstruction that achieves urethral closure under stress.
Concerning vulvar carcinoma, all of the following are true EXCEPT:
Evidence supports an HPV-dependent pathway of carcinogenesis with risks factors similar to vulvar intraepithelial neoplasia (VIN) in the majority of cases. Vulvar carcinomas are squamous in 90% of cases. Spread of vulvar carcinoma is by direct local extension and via lymphatic microembolization. Hematogenous spread is uncommon. Staging and primary surgical treatment are typically preformed as a single procedure and tailored to the individual patient.
Which of the following is true concerning endometrial carcinoma?
Endometrial cancer is the most common gynecologic malignancy and fourth most common cancer in women. It is most common in menopausal women in the fifth decade of life; up to 15 to 25% of cases occur prior to menopause, and 1 to 5% occur before age 40. Risk factors for the most common type of endometrial cancer include increased exposure to estrogen without adequate opposition by progesterone, either endogenous (obesity, chronic anovulation) or exogenous (hormone replacement). Additional risk factors include diabetes, Lynch II syndrome (hereditary nonpolyposis colorectal cancer), and prolonged use of tamoxifen. Tamoxifen is a mixed agonist/ antagonist ligand for the estrogen receptor. It is an agonistic in the uterus and an antagonistic to the breast and ovary. Protective factors for endometrial cancer include smoking and use of combination oral contraceptive pills.
Which of the following is FALSE concerning epithelial ovarian cancer (EOC) risk factors?
Risk factors for development of epithelial ovarian cancer (EOC) include events that appear to increase the number of lifetime ovulations ( eg, early menarche, late menopause, nulliparity), whereas events that decrease the number of ovulations decrease risk ( eg, pregnancy, breastfeeding, oral contraceptives). Additionally, a history of tubal ligation or hysterectomy also decreases EOC risk.
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