A 42-year-old woman is being evaluated because of urinary leakage over the several months. She reports involuntarily losing small amounts of urine after experiencing a sudden need to void. She has difficulty making it to the bathroom in time, these episodes occur almost every day and are very embarrassing. She has a history of multiple sclerosis. These symptoms have persisted despite 4 months of bladder training and weight loss, and reducing soda and coffee intake. Physical examination shows no abnormalities. A urinalysis is within normal limits.Her postvoid residual volume is low. Which of the following is the most likely explanation for her urinary symptoms?

Question

A 42-year-old woman is being evaluated because of urinary leakage over the several months. She reports involuntarily losing small amounts of urine after experiencing a sudden need to void. She has difficulty making it to the bathroom in time, these episodes occur almost every day and are very embarrassing. She has a history of multiple sclerosis. These symptoms have persisted despite 4 months of bladder training and weight loss, and reducing soda and coffee intake. Physical examination shows no abnormalities. A urinalysis is within normal limits.Her postvoid residual volume is low.  Which of the following is the most likely explanation for her urinary symptoms?

Quizplus · Accepted Answer

Eductional Objective: Patients with multiple sclerosis most commonly develop urge incontinence due to loss of central nervous system inhibition of detrusor contraction in the bladder.  As the disease progresses, the bladder can become atonic and dilated, leading to overflow incontinence.

A 42-Year-Old Woman Is Being Evaluated Because of Urinary Leakage