American Board of Internal Medicine (ABIM) Certification Practice Exam

What non-pharmacologic treatment is recommended for urinary urgency/frequency in multiple sclerosis?

1. Timed voids and avoidance of caffeine

2. Manual pelvic pressure and intermittent catheterization

3. Occupational therapy

4. Relaxation techniques and physical therapy

The correct answer is: Timed voids and avoidance of caffeine

Timed voids and avoidance of caffeine are non-pharmacologic treatments recommended for urinary urgency and frequency, particularly in patients with multiple sclerosis. This approach focuses on behavioral interventions that help manage the urinary symptoms associated with the condition. Timed voiding involves scheduling regular times to urinate, which can help train the bladder and reduce the urgency and frequency of episodes. Avoiding caffeine is also beneficial because caffeine can act as a diuretic and irritate the bladder, potentially worsening symptoms. Integrating these strategies can significantly enhance the quality of life for patients by providing control over their urinary symptoms without the need for medication, which could be associated with side effects or interactions. Other options listed might address different aspects of care but do not specifically target the management of urinary urgency and frequency as effectively as the combination of timed voiding and caffeine avoidance does.