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

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?

A) Detrusor muscle weakness
B) Hyperglycemia-induced osmotic diuresis
C) Low-grade cystitis causing bladder irritation
D) Pelvic floor laxity and urethral sphincter dysfunction
E) Uninhibited bladder contraction

Correct Answer:

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