Stress urinary incontinence in men.

Stress urinary incontinence is a distinctly unusual finding in men who have had no prior pelvic or urologic surgery. Seven men with stress urinary incontinence underwent urodynamic evaluation. All patients had urethral smooth muscle dysfunction manifested by decreased urethral pressure and the presence of radiographic contrast material in the proximal urethra. One patient with adenocarcinoma of the prostate had had a prior prostatectomy and subsequently had metastases with cauda equina compression. One patient had destruction of the pelvic plexus from metastastic choriocarcinoma. All other patients had neurologic lesions involving spinal roots L1 and/or L2, resulting in interference with adrenergic innervation of the proximal urethra. Thorough neurologic evaluation should be obtained in a man with stress urinary incontinence who has had no prior operation that could damage the pelvic plexus or urethral sphincter mechanisms.