LATEST OB/GYN – FEMALE PELVIC MEDICINE
& RECONSTRUCTIVE SURGERY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 55-year-old G3P3 presents with a sensation of
vaginal bulging for 6 months. On examination, the
anterior vaginal wall protrudes beyond the hymen (3
cm). The cervix is visible at the introitus with
Valsalva. What is the most appropriate POP-Q stage
for this patient?
A) Stage II (descent between 1 cm above and 1 cm
below the hymen)
B) Stage III (descent >1 cm below the hymen)
C) Stage IV (complete eversion)
D) Stage I (descent >1 cm above the hymen)
Correct answer: B
Rationale: POP-Q stage III: the most distal portion of
the prolapse is >1 cm below the hymen (but not
complete eversion). Stage IV is complete eversion.
,2. A 62-year-old female with stage III uterine prolapse
and stress urinary incontinence (SUI) desires
surgical treatment. She has completed childbearing
and is sexually active. What is the most appropriate
surgical procedure?
A) Vaginal hysterectomy with uterosacral ligament
suspension and mid-urethral sling
B) Sacrocolpopexy (abdominal) alone
C) Le Fort colpocleisis
D) Anterior colporrhaphy alone
Correct answer: A
Rationale: For uterine prolapse with SUI, vaginal
hysterectomy with apical suspension (uterosacral or
sacrospinous) and mid-urethral sling is appropriate.
3. A 45-year-old G2P2 presents with stress urinary
incontinence (SUI) for 2 years. She has no prolapse.
Urodynamics confirm urodynamic stress
incontinence (USI) with normal bladder capacity and
no detrusor overactivity. What is the most
appropriate first-line surgical treatment?
A) Mid-urethral sling (retropubic or transobturator)
B) Burch colposuspension
C) Pubovaginal sling (autologous fascia)
,D) Bulking agents
Correct answer: A
Rationale: Mid-urethral sling (retropubic or
transobturator) is the gold standard for surgical
treatment of SUI.
4. A 68-year-old female with stage IV pelvic organ
prolapse (complete eversion) and multiple medical
comorbidities is not sexually active. She desires a
low-risk, durable surgical option. What is the most
appropriate procedure?
A) Colpocleisis (Le Fort or total)
B) Sacrocolpopexy
C) Vaginal hysterectomy with sacrospinous fixation
D) Mesh-augmented vaginal repair
Correct answer: A
Rationale: Colpocleisis (obliterative procedure) is
highly effective for advanced prolapse in elderly, non-
sexually active women with minimal morbidity.
5. A 52-year-old G2P2 presents with urge urinary
incontinence (UUI) for 3 years. She has 10 episodes
of urgency incontinence per week. She has tried
behavioral therapy and pelvic floor muscle training
, without improvement. What is the most appropriate
next step?
A) Anticholinergic or beta-3 agonist (mirabegron)
B) OnabotulinumtoxinA (Botox) injection
C) Percutaneous tibial nerve stimulation (PTNS)
D) Sacral neuromodulation
Correct answer: A
Rationale: First-line pharmacotherapy for UUI is
anticholinergic (oxybutynin, tolterodine, solifenacin)
or beta-3 agonist (mirabegron).
6. A 58-year-old female with stage II cystocele and
stress urinary incontinence undergoes a mid-urethral
sling and anterior colporrhaphy. Postoperatively, she
develops urinary retention requiring intermittent
catheterization for 3 weeks. Urodynamics show no
detrusor contractions. What is the most appropriate
next step?
A) Continue intermittent catheterization (most cases
resolve by 4-6 weeks)
B) Sling release (cutting)
C) Urethral dilation
D) Alpha-blocker
Correct answer: A
& RECONSTRUCTIVE SURGERY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 55-year-old G3P3 presents with a sensation of
vaginal bulging for 6 months. On examination, the
anterior vaginal wall protrudes beyond the hymen (3
cm). The cervix is visible at the introitus with
Valsalva. What is the most appropriate POP-Q stage
for this patient?
A) Stage II (descent between 1 cm above and 1 cm
below the hymen)
B) Stage III (descent >1 cm below the hymen)
C) Stage IV (complete eversion)
D) Stage I (descent >1 cm above the hymen)
Correct answer: B
Rationale: POP-Q stage III: the most distal portion of
the prolapse is >1 cm below the hymen (but not
complete eversion). Stage IV is complete eversion.
,2. A 62-year-old female with stage III uterine prolapse
and stress urinary incontinence (SUI) desires
surgical treatment. She has completed childbearing
and is sexually active. What is the most appropriate
surgical procedure?
A) Vaginal hysterectomy with uterosacral ligament
suspension and mid-urethral sling
B) Sacrocolpopexy (abdominal) alone
C) Le Fort colpocleisis
D) Anterior colporrhaphy alone
Correct answer: A
Rationale: For uterine prolapse with SUI, vaginal
hysterectomy with apical suspension (uterosacral or
sacrospinous) and mid-urethral sling is appropriate.
3. A 45-year-old G2P2 presents with stress urinary
incontinence (SUI) for 2 years. She has no prolapse.
Urodynamics confirm urodynamic stress
incontinence (USI) with normal bladder capacity and
no detrusor overactivity. What is the most
appropriate first-line surgical treatment?
A) Mid-urethral sling (retropubic or transobturator)
B) Burch colposuspension
C) Pubovaginal sling (autologous fascia)
,D) Bulking agents
Correct answer: A
Rationale: Mid-urethral sling (retropubic or
transobturator) is the gold standard for surgical
treatment of SUI.
4. A 68-year-old female with stage IV pelvic organ
prolapse (complete eversion) and multiple medical
comorbidities is not sexually active. She desires a
low-risk, durable surgical option. What is the most
appropriate procedure?
A) Colpocleisis (Le Fort or total)
B) Sacrocolpopexy
C) Vaginal hysterectomy with sacrospinous fixation
D) Mesh-augmented vaginal repair
Correct answer: A
Rationale: Colpocleisis (obliterative procedure) is
highly effective for advanced prolapse in elderly, non-
sexually active women with minimal morbidity.
5. A 52-year-old G2P2 presents with urge urinary
incontinence (UUI) for 3 years. She has 10 episodes
of urgency incontinence per week. She has tried
behavioral therapy and pelvic floor muscle training
, without improvement. What is the most appropriate
next step?
A) Anticholinergic or beta-3 agonist (mirabegron)
B) OnabotulinumtoxinA (Botox) injection
C) Percutaneous tibial nerve stimulation (PTNS)
D) Sacral neuromodulation
Correct answer: A
Rationale: First-line pharmacotherapy for UUI is
anticholinergic (oxybutynin, tolterodine, solifenacin)
or beta-3 agonist (mirabegron).
6. A 58-year-old female with stage II cystocele and
stress urinary incontinence undergoes a mid-urethral
sling and anterior colporrhaphy. Postoperatively, she
develops urinary retention requiring intermittent
catheterization for 3 weeks. Urodynamics show no
detrusor contractions. What is the most appropriate
next step?
A) Continue intermittent catheterization (most cases
resolve by 4-6 weeks)
B) Sling release (cutting)
C) Urethral dilation
D) Alpha-blocker
Correct answer: A
