Gynaecological oncology: bladder dysfunction after radical hysterectomy: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Gynaecological oncology: bladder dysfunction after radical hysterectomy

Sample item

After a Wertheim radical hysterectomy, a woman cannot sense bladder filling and has difficulty voiding. What is the cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Injury to pelvic autonomic nerves in the cardinal and uterosacral ligaments

Radical hysterectomy removes the parametrium, including the cardinal and uterosacral ligaments that carry the inferior hypogastric plexus. Disruption of this nerve supply causes bladder atony and sensory loss. Nerve-sparing techniques aim to reduce this complication.

Option by option

  • A. Injury to pelvic autonomic nerves in the cardinal and uterosacral ligaments (correct)

    Correct. Division of the autonomic fibres explains the symptoms.

  • B. Damage to the pudendal nerve

    The pudendal nerve supplies the perineum and external urethral sphincter and is not divided.

  • C. A vesicovaginal fistula

    A fistula causes continuous urinary leakage rather than retention.

  • D. Ligation of a ureter

    Ureteric ligation causes hydronephrosis and loin pain rather than voiding difficulty.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Injury to pelvic autonomic nerves in the cardinal and uterosacral ligaments. Radical hysterectomy removes the parametrium, including the cardinal and uterosacral ligaments that carry the inferior hypogastric plexus.

Why is "Damage to the pudendal nerve" not the answer?

The pudendal nerve supplies the perineum and external urethral sphincter and is not divided.

Why is "A vesicovaginal fistula" not the answer?

A fistula causes continuous urinary leakage rather than retention.

Why is "Ligation of a ureter" not the answer?

Ureteric ligation causes hydronephrosis and loin pain rather than voiding difficulty.

What concept does this question test?

It tests Gynaecological oncology: bladder dysfunction after radical hysterectomy in OBG. Disruption of this nerve supply causes bladder atony and sensory loss. Nerve-sparing techniques aim to reduce this complication.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gynaecological oncology: bladder dysfunction after radical hysterectomy?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.