Involuntary bladder leakage can affect both men and women of all ages, and is often caused by nerve damage, urine flow backup or weak pelvic floors. Treatments include pelvic strengthening exercises, diet and lifestyle changes, and surgical options.

For more information on urinary incontinence in women and treatment options, visit our female pelvic medicine section.

Benign prostatic hyperplasia (BPH) is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. The exact etiology is unknown. The enlarged gland has been proposed to contribute to the overall lower urinary tract symptoms and dysfunction. There are medicines that can help improve these symptoms as well minimally invasive treatments that are available.  Our physicians perform all surgical options including transurethral resection of the prostate (TURP), Urolift, Laser prostatectomy, Electrovaporazation of the prostate, Robotic procedures as well as Aquablation which is a new therapy only offered at Einstein in this area and regionally.

Trouble urinating or the inability to urinate are known as voiding disorders, which are often caused by bladder infections, inflammation or neurologic or anatomic issues such as BPH. Treatments include pelvic strengthening exercises, medications, diet and lifestyle changes, and surgical options.

Urinary tract infections (UTIs) are bacterial infections that can affect the kidneys, bladder and urethra. Symptom may include painful urination or a burning sensation, more frequent urination, constant urge to urinate, feeling the bladder is constantly full, abdominal discomfort, and cloudy, milky or bloody urine. Men may also experience a feeling of fullness in the rectum. Infections that have spread to the upper urinary tract and kidneys may cause symptoms such as fever, chills, general discomfort and pain between the ribs or in the abdomen or sides.

UTIs are more common in women. Women who have uterine prolapse, are postmenopausal or engage in increased sexual activity are at higher risk for UTIs. Men with kidney stones, enlarged prostates and poor bladder control are also at higher risk. UTIs are often preventable by drinking water and urinating when necessary. Women can prevent UTIs by wiping from front to back to reduce spreading bacteria, cleansing the vaginal region before intercourse, and avoiding vaginal hygiene products.

In most cases, UTIs can be successfully treated with antibiotics. However, if the infection is related to a kidney stone, enlarged prostate or other abnormality, further treatment may be necessary..

When the bladder doesn't empty completely, urine can crystallize into painful stones that cause lower abdominal pain, painful and frequent urination, bloody or cloudy urine and, in men, pain or discomfort in the penis. Bladder stones may be caused by urinary tract infections, damaged nerves, a weakened bladder wall and, in men, an enlarged prostate.

Most bladder stones are treated using a procedure called a transurethral cystolitholapaxy. Using a rigid tube to insert a small camera into your bladder, your urologist will locate the stones and use a laser to break them apart so they can be removed.

Some urinary problems may be caused by neurologic conditions, such as spinal cord injury, spina bifida, stroke, Parkinson's disease and multiple sclerosis. Treatments for neurologic bladder conditions include:

• Behavioral counseling
• Oral medications to relax the bladder
• Scheduled self-catheterization
• Surgical placement of a catheter through the abdominal wall into the bladder
• Botox injections to relax the bladder muscle
• An electrical implant in the lower back that delivers electrical stimulation of the nerve that controls the bladder, known as sacral neuromodulation
• Surgically enlarging the bladder using a segment of the patient’s intestine, often with a channel that permits catheterization through an opening on the abdomen
• Removal of the bladder with urinary drainage via a pouch that is catheterized to empty or a stoma with continuous urine drainage into an appliance

Einstein's reconstructive urology team has expertise in open and minimally-invasive surgical approaches to neurogenic bladder. Many of these surgeries may be performed in a completely minimally-invasive fashion through a series of small incisions, reducing postoperative pain and potentially accelerating recovery.

If you have had your bladder removed, or have a condition that requires a temporary or permanent urinary diversion, your surgeon may place a port in your lower abdomen that allows urine to flow into a urostomy bag that is typically worn around the waist or on the leg.

Using tissue from part of your intestine to create a new bladder, this procedure can restore proper function to your urinary system, and may be an alternative for those who may otherwise need to use a urostomy bag permanently.