You are not alone
Leaking urine is common in both women and men, but it is not a normal part of aging that you have to accept. Effective treatment exists for nearly every type, and many people improve without surgery.
Types of incontinence
- Stress incontinence: leaking with coughing, sneezing, lifting or exercise, often after childbirth or, in men, after prostate surgery.
- Urge incontinence and overactive bladder: a sudden, strong need to urinate with leakage before reaching the bathroom.
- Mixed incontinence: features of both.
- Overflow incontinence: leaking because the bladder does not empty well.
Evaluation
Dr. Neal Patel begins with a careful history, a bladder diary, a urine test to rule out infection, and a measurement of how well the bladder empties. Some patients benefit from urodynamic testing, which measures bladder pressure and function, or cystoscopy. Identifying the type of incontinence matters because the treatments are different.
Treatment options
First steps include pelvic floor muscle training (often with a physical therapist), fluid and caffeine adjustments, weight management and timed voiding. For overactive bladder, medications, tibial nerve stimulation, bladder Botox injections and sacral neuromodulation are proven options. For stress incontinence in women, options include urethral bulking and sling procedures. For men with leakage after prostate surgery, options include male slings and the artificial urinary sphincter. Dr. Neal Patel tailors the plan to your symptoms, health and goals.
Advanced options and recognition
For overactive bladder that has not improved with first-line care, Dr. Neal Patel offers tibial nerve stimulation (in-office percutaneous sessions or a small implant near the ankle), bladder Botox and sacral neuromodulation. Advanced Urology is recognized as a Medtronic World Center of Excellence on Advanced Overactive Bladder Therapies.
Leakage after prostate surgery
Men who still leak with coughing or activity a year or more after prostate surgery may be candidates for ProACT adjustable continence therapy, a minimally invasive balloon implant that can be adjusted in the office. Male slings and the artificial urinary sphincter are other options.
Next step
Call 678-344-8900. Female and male patients are seen at Johns Creek, Cumming, Decatur and Braselton.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.