Urination (Voiding) Problems

The urologists at NewYork-Presbyterian Brooklyn Methodist understand how difficulty urinating can impair your quality of life. Our team is highly experienced in the care of patients with incontinence (trouble holding your urine), overactive bladder, underactive bladder, and other urination problems. If your treatment requires surgery, we have exceptional experience in the use of robotic-assisted surgery to treat urination problems.

Assessing Urodynamics

We conduct a variety of tests to assess your urinary function and determine the cause of your symptoms. With the results of these tests, we can make an accurate diagnosis and tailor the most effective therapy for you. The tests include:

  • Urodynamic studies to measure how well your bladder holds and empties urine.
  • Cystoscopy, a test in which a scope is used to examine your bladder and urethra.
  • Nervous system evaluation using imaging tests like MRI and CT scans.

Comprehensive Care for Overactive Bladder

If you find yourself feeling the urge to urinate many times a day and it also makes you get up at night, you may have overactive bladder. Our urologists offer a combination of therapies to treat overactive bladder, such as "bladder retraining" therapy and medication. We also perform botulinum toxin (Botox) injections into the bladder to relax and paralyze the overactive muscle. In severe cases that don't respond well to other therapies, we may use percutaneous nerve stimulation: implantation of a small pacemaker that sends impulses to the sacral nerve, which controls the bladder.

Neurogenic Bladder Treatment

With neurogenic bladder, the nerves that control the urinary system and signal when urine should be held in or released from the bladder do not function properly, and patients lose bladder control. The bladder can become either overactive (causing increased urge to urinate or leakage) or underactive (causing retention of urine), depending on the origin of the problem. The urologists at NewYork-Presbyterian Brooklyn Methodist offer bladder retraining, medications, and the insertion of a catheter to drain urine for people with neurogenic bladder. If these treatments are not sufficient for relieving symptoms, our urologists offer surgery for neurogenic bladder.

Treating Urinary Incontinence

Our urologists evaluate and treat men and women with urinary incontinence that isn't due to overactive bladder or neurogenic bladder, offering bladder retraining, medications, and dietary modifications to help you gain better control over urination. You may also benefit from pelvic muscle rehabilitation, such as Kegel exercises, which we may teach you to do in combination with biofeedback (to gain awareness and control of your pelvic muscles) or pelvic floor electrical stimulation (to spur muscle contractions).

Some people require surgery for stress urinary incontinence, such as implantation of a vaginal sling in women, insertion of a male sling in men, implantation of an artificial urinary sphincter, or injection of a urethral bulking agent. For urgency incontinence, we offer sacral neuromodulation (InterStim) and injection of botulinum toxin into the bladder.