title: Characteristics and outcomes of men who fail to leak on intubated urodynamics prior to artificial urinary sphincter placement.
abstract: BACKGROUND
  To report the characteristics and anti-incontinence outcomes of men who fail to demonstrate incontinence on intubated urodynamics (UDS).
  
  
  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.
authors.affiliation: Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Weissbart
authors.forename: Karl
authors.initials: K
authors.lastname: Coutinho
authors.forename: Bilal
authors.initials: B
authors.lastname: Chughtai
authors.forename: Jaspreet S
authors.initials: JS
authors.lastname: Sandhu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005355:Fibrosis / Q000150:complications / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D011471:Prostatic Neoplasms / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology; D014525:Urethral Stricture / Q000150:complications / Q000209:etiology; D062885:Urinary Catheters; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014636:Valsalva Maneuver / Q000502:physiology