CLINICAL FELLOWSHIP IN UROGYNECOLOGY,
PELVIC RECONSTRUCTION, AND NEURO UROLOGY
in the
DEPARTMENT OF UROLOGY
at the
JEWISH GENERAL HOSPITAL, MONTREAL, CANADA
Length of the fellowship
Nominally one year — however a two-year fellowship is possible and, in fact, recommended in order that the fellow may fully realize all his (her) objectives.
General Objectives
At the end of their fellowship, the physician 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-on-one on a daily basis) at the clinic, the wards, the cystoscopy suites, the urodynamic lab, and the operating rooms at the Jewish General Hospital (JGH) and the Royal Victoria Hospital (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 Montreal Shriners Hospital
- the department and McGill University libraries
- any other opportunities considered relevant and useful by Dr. Corcos and/or Dr. Lemieux
Evaluation of performance
Performance review/feedback sessions will be held during the last week of September, the third week of December and the last week of March, with final assessment occurring during the second week of June in year of fellowship. For each of these assessments a written report will be sent to the fellow and to the Program Director.