A 36-year-old woman comes to the office due to frequent urination since an exacerbation of multiple sclerosis 2 months ago. Most of her symptoms, including dizziness, leg weakness, and numbness, have improved with corticosteroid treatment. However, she has continued difficulty holding urine, and on several occasions has passed a small amount of urine while trying to reach the bathroom. She has no urine leakage during coughing or sneezing. The patient has no other medical problems. On examination, the patient has mild spastic paraparesis with increased reflexes in the lower extremities; bilateral Babinski sign; and a thoracic sensory level to pain, temperature, and vibration. An MRI of the spine reveals a new demyelinating lesion in the mid-thoracic spinal cord. Which of the following abnormalities will most likely be found on this patient's urodynamic studies?

Question

A 36-year-old woman comes to the office due to frequent urination since an exacerbation of multiple sclerosis 2 months ago.  Most of her symptoms, including dizziness, leg weakness, and numbness, have improved with corticosteroid treatment.  However, she has continued difficulty holding urine, and on several occasions has passed a small amount of urine while trying to reach the bathroom.  She has no urine leakage during coughing or sneezing.  The patient has no other medical problems.  On examination, the patient has mild spastic paraparesis with increased reflexes in the lower extremities; bilateral Babinski sign; and a thoracic sensory level to pain, temperature, and vibration.  An MRI of the spine reveals a new demyelinating lesion in the mid-thoracic spinal cord.  Which of the following abnormalities will most likely be found on this patient's urodynamic studies?

Quizplus · Accepted Answer

Eductional Objective: Patients with multiple sclerosis often develop a spastic bladder a few weeks after developing an acute lesion of the spinal cord.  These patients present clinically with increased urinary frequency and urge incontinence.  Urodynamic studies show the presence of bladder hypertonia.

A 36-Year-Old Woman Comes to the Office Due to Frequent