72-year-old man comes to the emergency department due to a 24-hour history of progressive lower abdominal discomfort and
difficulty voiding. The patient has never had urinary difficulty in the past He has a history of hypertension, ischemic stroke with mild
left-sided residual weakness, and a recent episode of abdominal shingles The patient also reports several days of non-productive
cough and has been taking over-the-counter diphenhydramine for 2 days He is a former smoker and does not drink alcohol.
Temperature is 36.7 C (98 F), blood pressure is 150/80 mm Hg, and pulse is 105/min. The patient appears restless. Bilateral breath
sounds are normal with no added sounds. Cardiac examination reveals regular rhy1hm. Previous area of shingles on the abdominal
wall has no active lesions but the area is hyperesthetic There is suprapubic fullness and tenderness. A mildly enlarged, nontender
prostate is palpated on the rectal examination. Which of the following is the most likely cause of this patient’s current condition?
- QA Abdominal muscle weakness
- 0 B. Bladder motor nerve injury
- 0 C. Detrusor hypocontractility
- 0 D. Internal sphincter spasm
- 0 E. Urethral extrinsic compression
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