Clinical Fellowship in Urogynecology

Clinical Fellowship in Urogynecology

Clinical Fellowship in Urogynecology

in the
at the

(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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