Aortic occlusion and lower extremity exercise induced stress urinary incontinence

An unusual case of intermittent stress urinary incontinence associated with lower extremity exercise in a patient with aortoiliac occlusive disease is reported. Preoperative noninvasive vascular testing revealed severe compromise of lower extremity and pelvic blood flow. Fluoroscopically guided preoperative urodynamic evaluation without exercise revealed a competent urethral sphincter mechanism that became incompetent following exercise sufficient to induce claudication. The claudication and exercise-induced incontinence resolved after aortobifemoral bypass, and postoperative urodynamic studies were normal.