Characteristics and outcomes of men who fail to leak on intubated urodynamics prior to artificial urinary sphincter placement Journal Article


Authors: Weissbart, S. J.; Coutinho, K.; Chughtai, B.; Sandhu, J. S.
Article Title: Characteristics and outcomes of men who fail to leak on intubated urodynamics prior to artificial urinary sphincter placement
Abstract: INTRODUCTION: To report the characteristics and anti-incontinence outcomes of men who fail to demonstrate incontinence on intubated urodynamics (UDS). MATERIALS AND METHODS: From 2005 to 2013, the records of men who underwent UDS prior to artificial urinary sphincter (AUS) were reviewed. The histories, UDS, endoscopies, and anti-incontinence outcomes of men who failed to demonstrate incontinence on intubated UDS were recorded. In our UDS protocol, the urodynamic urethral catheter was removed and the UDS was repeated to elicit incontinence without the urethral catheter. The valsalva leak point pressure (VLPP) was obtained via the rectal catheter in these men. RESULTS: All men were status post radical prostatectomy for prostate cancer. Nineteen percent (32) of the study population (169) had non-demonstrable incontinence on intubated UDS. Mean age at the time of UDS was 62 (range 48-81). All patients demonstrated incontinence on UDS upon removal of the urethral catheter. Their mean VLPP was 79.3 (SD 36.7). Fifty-six percent (18) of these men had an anastomotic stricture (AS) and 37.5% (12) had a history of radiotherapy treatment, of which six also had an AS. Mean pads per day at the time of UDS was 4.6 (SD 2.9). At a mean follow up of 40.7 months (SD 24.7) from AUS placement, mean pads per day was 0.87 (SD 1.2). CONCLUSIONS: Men who fail to demonstrate incontinence on intubated UDS have a high rate of AS and history of radiotherapy treatment, which is a known cause for urethra fibrosis and scarring. Regardless, these men can achieve excellent anti-incontinence outcomes.
Keywords: treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; multimodality cancer therapy; pathophysiology; combined modality therapy; radiotherapy; pathology; retrospective study; physiology; prostatic neoplasms; fibrosis; prostatectomy; urologic surgery; urologic surgical procedures; urinary catheter; valsalva maneuver; urinary incontinence; urethra; adverse effects; complication; bladder sphincter prosthesis; urinary sphincter, artificial; urodynamics; devices; procedures; urethral stricture; very elderly; humans; human; male; urinary catheters
Journal Title: Canadian Journal of Urology
Volume: 21
Issue: 6
ISSN: 1195-9479
Publisher: Canadian Journal of Urology  
Date Published: 2014-12-01
Start Page: 7560
End Page: 7564
Language: English
PUBMED: 25483765
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 2 October 2015 -- Source: Scopus