A 42-Year-Old Man with a Long History of Type 1

A 42-year-old man with a long history of type 1 diabetes mellitus comes to the office due to frequent involuntary loss of urine.  For the past several months, he has been having difficulty starting and maintaining a urinary stream.  In the last 3 weeks, he has had 2 episodes of nocturnal enuresis and multiple daytime episodes of uncontrolled voiding without any sensation of a full bladder.  His other medical problems include chronic kidney disease and gastroparesis.  He does not use tobacco or alcohol.  Which of the following additional findings would most likely be present in this patient?

A) Enlarged prostate on rectal examination
B) Increased postvoid residual volume
C) Loss of sensation in perineal area
D) Lower extremity hyperreflexia
E) Mini-mental state examination score of 22

Correct Answer:

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