Clinical Fellowship in Urogynecology

Clinical Fellowship in Urogynecology

Clinical Fellowship in Urogynecology

CLINICAL FELLOWSHIP IN UROGYNECOLOGY, PELVIC RECONSTRUCTION, AND NEUROUROLOGY
in the
DEPARTMENT OF UROLOGY
at the
JEWISH GENERAL HOSPITAL

(February 2006)


Length of the fellowship
One year, however a 2 years fellowship is possible and even recommended to fully reach all the objectives.



General Objectives

At the end of their fellowship the physicians will be able to handle a general practice in urogynecology.

Specific Objectives
For each of the following topics the physician will be able to:

  • describe the related anatomy
  • detail the pathophysiology processes
  • organize and explain all steps of evaluation
  • perform these evaluations (see evaluation)
  • describe non-pharmacological and/or pharmacological and/or surgical treatment and to discuss their respective indications, contraindications and side effects
  • discuss the management of complications related to these treatments


List of Topics

  • anterior vaginal prolapse
  • enterocele
  • rectocele
  • vault prolapses (abdominal and vaginal approaches)
  • hysterectomies
  • vesicovaginal fistulae
  • urethral fistulae
  • urethral diverticulum
  • gynaecological developmental anomalies
  • pediatric neurogenic bladders
  • adult neurogenic bladders
  • cystitis and urethritis
  • overactive bladder
  • urethral syndrome
  • vaginitis
  • pelvic pain syndrome
  • urological changes and complications of pregnancy
  • menopause
  • anal incontinence *

* theory only, no surgical exposure


Additional Specific Surgical Objectives

  • At the end of the training the fellow will be able to perform:
  • intra urethral injection therapy
  • vaginal approaches for the treatment of SUI
  • needle suspensions
  • retropubic cystourethropexies
  • laparoscopic colposuspension *
  • sling procedures (organic and artificial)
  • artificial urinary sphincter in females
  • electrical implant for the treatment of voiding dysfunction
  • complex reconstructive urological surgery

and to discuss..

  • effects of pelvic surgery on the lower urinary tract


Other Specific Objectives
At the end of the training the fellow will be able to:

  • discuss the history of urogynecology
  • describe epidemiological issues on urogynecologic topics in North America
  • choose the best QoL instrument and criticize the literature regarding quality of life assessment in UI
  • classify voiding dysfunction
  • describe basic embryology of bladder and urethra
  • review and criticize the drugs used for treatment of bladder dysfunction in women
  • perform and analyse voiding diaries
  • perform and analyse a pad test
  • perform and analyse a urodynamic and video-urodynamic test
  • analyse and criticize a nerve conduction test
  • perform and interpret a voiding cystogram, an IVP, a hysterography, pelvic floor MRI, transvaginal US
  • perform and comment on a cystoscopy
  • describe, criticize, and set-up a plan of treatment using behavioural therapy and physiotherapy in the treatment of UI
  • comment on prevention of incontinence an prolapse


In order to reach these objectives, the fellow will have access to:

  • Dr. Corcos and Dr. Lemieux’s teaching (one by one teaching on a daily basis) at the clinic, the wards, the cystoscopy suites, the urodynamic lab, and the operating room at the JGH and the RVH
  • the radiology department at the JGH for MRI, transvaginal US, obstetrical US
  • private physiotherapy clinics
  • the neuro-urology clinics at the Institute de Réadaptation de Montréal and the Shriners Hospital
  • the department and McGill librairies
  • any other opportunities considered as useful by Dr. Corcos and/or Dr. Lemieux


Evaluation of performance
A discussion about performance and feed-back session will be held during the last week of September, the third week of December, the last week of March and a final assessment will occur the second week of June of each year of fellowship. For each of these assessments a written report will be sent to the fellow and to the program director.

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