Urinary Incontinence
Urinary incontinence is the involuntary leakage of urine. Though this condition affects millions of Americans, it’s not an inescapable part of life. In most cases, it is preventable. Otherwise it is treatable with lifestyle changes and other treatment approaches.
At NewYork-Presbyterian, we offer a range of treatment options for urinary incontinence, whether you’re frequently wetting yourself or experiencing slight leakage.
Diagnosing Urinary Incontinence
Cases of urinary incontinence can often be caused by anatomic changes to your genitourinary tract, the use of certain medications, the onset of an illness, or due to chronic disease. For women, urinary leakage or wetting can often occur during pregnancy, after childbirth, and around menopause. It can often be due to a pelvic floor disorder such as vaginal prolapse or a weakened sphincter muscle.
If you have urinary incontinence, seek medical treatment from a physician familiar with the types of urinary incontinence and the conditions that may increase your chance of developing urinary incontinence.
The urologic experts at NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian/Columbia University Medical Center are leaders in the diagnosis and treatment of urinary incontinence. As part of the No. 1 hospital in New York, our patients have access to a referral network of more than 5,000 physicians who can help treat the underlying cause of UI.
Types of urinary incontinence
- Stress urinary incontinence (caused by physical activities): leakage during physical activity, such as exercise, coughing, laughing, sneezing, or other body movements that increase abdominal pressure.
- Urge urinary incontinence: leakage preceded by a sudden desire to urinate which can’t be postponed.
- Mixed urinary incontinence: a mix of stress and urge incontinence.
- Overflow urinary incontinence: leakage that occurs when the bladder is not draining properly, causing urine to overflow.
- Functional urinary incontinence: leakage due to an underlying medical condition, such as arthritis, that prevents a person from making it to the restroom in time to urinate.
Our Approach to Urinary Incontinence
At NewYork-Presbyterian, we tailor treatment options to account for each patient’s age, overall health, associated conditions, and severity of the urinary incontinence. Armed with that information, our specialists typically prescribe a combination of the following approaches:
Behavioral therapies and dietary modifications. Our team of social workers, nutritionists, physical therapists, and urologists work with you to modify behaviors that contribute to urinary incontinence. Therapies include:
- Bladder retraining to teach people to resist the urge to void and to gradually expand the intervals between voiding.
- Routine or timed and scheduled toileting.
- Prompted voiding to help people empty their bladders regularly to prevent leaking.
- Weight loss (for patients who are obese or significantly overweight) to reduce the pressure on organs and tissues.
- Nutritional education on fluid intake, a healthy diet and modifying or eliminating caffeine (coffee, soda, and tea).
Pelvic muscle rehabilitation. Kegel (pelvic floor) exercises can help strengthen the pelvic floor to reduce or eliminate the symptoms of UI. Biofeedback used in conjunction with Kegel exercises helps people gain awareness and control of their pelvic muscles.
Medication management. Antimuscarinic drugs (Ditropan, Detrol, Oxytrol, Enablex, Sanctura, Toviaz and Vesicare) or Beta-3 agonists (Myrbetriq) are highly effective in treating urge incontinence. In postmenopausal women, topical estrogen may be used to help control urge incontinence.
Office-based procedures. Posterior tibial nerve stimulation uses acupuncture like needle to control the overactive bladder and urgency incontinence. This therapy is done weekly to start and eventually monthly and helps to improve overall quality of life.
Intravesical Botox. Botox can be injected into the bladder muscle itself to slow down the overactive bladder muscles and decreased overactive bladder symptoms.
Surgery. Our highly skilled urologic surgeons can perform specific surgeries to correct conditions that can cause incontinence when other treatment options do not work. Our urologic surgeons can implant bulking agents to support the bladder neck or perform midurethral sling procedures to support the urethra and bladder for stress incontinence. Finally, InterStim—a pacemaker-like device to control the bladder—can be implanted for urge incontinence.
Appointments & Referrals
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Refer a patient
At NewYork-Presbyterian, we treat a diverse patient population with conditions ranging from the most common to the rarest and most complex. Clinicians in private practice or at other hospitals are welcome to refer their patient to NewYork-Presbyterian. Please call 212-305-0114, 646-962-4811, or 646-962-9600 to arrange a referral.