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Urogynecology
 
Introduction
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Goals & Objectives
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Goals and Objectives

The overall educational goal for the rotating student is to gain experience in the sub-specialty of urogynecology. The rotating student will work directly with the attending physicians and see patients daily in both the women’s pavilion and in the operating room at Geisinger Medical Center, Danville, PA. Medical students will gain expertise in both urogynecology and pelvic floor dysfunction by participating in the initial evaluation and management of women with these disorders in the urogynecology clinic. The medical student will continue to develop clinical expertise by having direct experiences in the additional evaluation and treatment of patients presenting with urogynecologic and related disorders. 

Specific learning objectives are as follows: 

1. The medical student will gain an understanding of a systematic approach to the evaluation and treatment of patients presenting with urogynecologic and related disorders. 

a. Perform the incontinence work-up, including the interpretation of studies such as urodynamics, cystoscopy, and cystometrograms  

b. Identify options for medical treatment for incontinence 

c. Become familiar with surgical options for treatment of incontinence and pelvic floor dysfunction 

d. Participate in the evaluation, diagnosis, and treatment for prolapse and pelvic floor dysfunction 

e. To recognize the morbidity of treatments and the psychosocial issues in the incontinent and elderly patient 

2. The medical student will acquire, appropriate to the level of clinical training, the following core knowledge base in urogynecology: 

a. The normal urinary tract and pelvic floor

  • Embryology
  • Anatomy
  • Physiology
  • The urinary tract in pregnancy 

b. Lower urinary tract dysfunction

  • H&P
  • Urodynamic evaluation
  • Urinary incontinence - general considerations
  • Genuine stress incontinence
  • Detrusor instability
  • Voiding abnormalities
  • Urinary tract infections
  • Urethral disorders
  • Intraoperative injuries
  • Urinary tract fistulae
  • Neoplasia
  • Psychological impact of GU disorders 

c. Genital prolapse

  • Pathophysiology
  • Diagnosis
  • Treatment 

d. Anal Incontinence and rectal prolapse

  • Pathophysiology
  • Diagnosis
  • Treatment 

3. The medical student will acquire, appropriate to the level of clinical training, knowledge and understanding of the following as they pertain to the clinical practice of urogynecology: 

a. Principles and interpretation of multichannel urodynamics

b. Differential diagnosis of incontinence

c. Normal and pathologic micturition

d. Fistulas

e. Effect of pelvic tumors on the urinary tract

f. Pelvic floor and urinary tract anatomy abnormalities

g. Anatomy and physiology of anal incontinence and rectal prolapse

h. Operations for incontinence and pelvic floor relaxation

i. Postoperative care after surgery for incontinence and prolapse 

4. The medical student will demonstrate ability to perform, at the minimum, the following clinical and procedural skills at a satisfactory level for the level of training:

a. Clinical examination including evaluation of pelvic floor function.

b. Clinical stress test

c. Fitting of pessaries

d. Management of pessaries 

5. The medical student will demonstrate motivation and ability to gain proficiency in performing the following clinical and procedural skills:

a. Cystoscopy

b. Evaluation of the upper urinary tract (ultrasound/X-ray)

c. Basic urodynamics 

 
 
 
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This page was last modified on  10/12/2011