Urinary Incontinence

At Montefiore Einstein Urology, you can access exceptional care for urinary incontinence. As a global leader in urology, we are an academic-based, national and international referral site for the most complex and high-risk cases. For more than a century, we have been at the forefront of innovation, research, and clinical care for genitourinary (GU) conditions. 

Ranked in the top 1% of all hospitals in the nation for urology according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of GU conditions. Our multidisciplinary team of world-renowned specialists is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.  

At Montefiore Einstein Urology, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety. In addition, we offer patients a full range of support services, from nutritional guidance to rehabilitative therapies.  

When you need urinary incontinence care, turn to our dedicated multidisciplinary team for a personalized treatment plan.

• Urge incontinence, often referred to as overactive bladder: an urgent, uncontrollable need to urinate during the day or night
• Stress incontinence: the most common type of urinary incontinence, causing urine leakage during laughing, coughing, sneezing, or exercise
• Functional incontinence: loss of bladder control due to an underlying medical condition, leading to difficulty reaching the bathroom before leaking or urination
• Overflow incontinence: persistent urine leakage caused by urinary retention, often due to a bladder obstruction, enlarged prostate, severe pelvic organ prolapse or other condition causing the bladder to become too full and overflow
• Mixed incontinence: a combination of several types of urinary incontinence

There are numerous causes of urinary incontinence ranging from weak bladder or pelvic floor muscles, overactive bladder muscles, neurogenic bladder (damage to nerves that control the bladder from diseases such as diabetes, multiple sclerosis, Parkinson’s Disease and spinal cord injury), urinary tract or vaginal infections, certain medications, pregnancy, childbirth, hysterectomy, menopause, constipation, bladder stones,  as well as arthritis and other conditions that make it difficult to reach the bathroom in time. Urinary incontinence in men is also often related to prostate conditions such as benign prostatic hyperplasia, prostatitis, or injury or damage to the nerves or muscles around the bladder from prostate surgery (especially radical prostatectomy) or radiation therapy. 

The degree and frequency of involuntary leakage of urine can vary depending on the type of urinary incontinence. Urine leakage can occur during exercising, lifting, sneezing, coughing or bending, during sexual activity or without any warning or urge. Individuals may experience a sudden urge to urinate but are unable to hold in their urine or they may be unable to reach the bathroom in time.

The diagnosis of urinary incontinence often includes a detailed history and thorough physical examination. Some of the diagnostic tests may include a urinalysis, post-void residual volume, and obtaining a 24-hour pad test or a 24-hour or 3-day voiding diary in some cases. Urodynamic testing and/or a cystoscopy may also be obtained in certain cases. A renal ultrasound can be considered in patients with renal failure or suspected hydronephrosis (swelling of one or both of the kidneys due to a blockage of urine outflow).

Treatment for urinary incontinence varies depending on the type of urinary incontinence, patient’s symptoms, age, general health and cause of the underlying condition and can include:

• Monitoring diet and activity: weight loss can significantly improve your symptoms, identifying potential bladder irritants including tea, coffee, alcohol, caffeinated soft drinks, fruit juices, chocolate, tomato-based foods, spicy/acidic floods, artificial sweeteners
• Control of other medical problems that may affect the bladder function
• Bladder retraining: resetting your bladder muscles by resisting feelings of urgency, delaying trips to bathroom, or pee according to timetable
• Non-surgical treatment such as dietary and lifestyle changes, behavioral therapy including fluid management and bladder training, physical therapy, Kegel and pelvic floor exercises, incontinence products and devices such as catheters or absorbent pads, pessaries, and medications
• Interventional therapies such as sacral neuromodulation, posterior tibial nerve stimulation, Botox injections, and urethral bulking agents
• Specialized surgical procedures such as urethropexy, Burch colposuspension, native fascial slings, and synthetic midurethral slings