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16 patients with multiple sclerosis, complaining of urgency, frequency and urge incontinence were studied urologically. They all suffered from detrusor hyperreflexia. We managed to improve this disturbance by lowering the parasympathetic tone and at the same time increasing the sympathetic tone of the urinary outlet, using a combination of imipramine and propantheline. The subjective clinical alleviation was also corroborated by cystomanometry and urethral pressure profile before and after treatment.
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