Urinary Health

AHN physicians are skilled at diagnosing and treating male urinary disorders, including difficulty urinating as well as urinary incontinence.

Overactive bladder: Urinary incontinence

Urinary incontinence often results from issues with nerve signals from the brain to your bladder. Other times, issues are due to the urinary sphincter not working correctly.

Types of urinary incontinence

• Stress urinary incontinence: This occurs with increased force on your pelvic floor — a collection of nerves, muscles, and ligaments — from common activities like sneezing, coughing, laughing, exercising, lifting, and standing up after sitting. It’s often caused by weakness in the urinary sphincter or pelvic floor, which most often occurs after surgery or as a result of trauma.
• Urge urinary incontinence: This is the sudden uncontrollable urge to urinate, which may result in incontinence. This is commonly associated with overactive bladder. Possible causes can include a urinary tract infection or neurologic conditions like multiple sclerosis, Parkinson’s disease, or a history of stroke.

Diagnosing urinary incontinence

• History and physical exam: Your provider will discuss your urinary symptoms then perform a physical exam and digital rectal exam (DRE) to feel the prostate gland.
• Labs: A urinalysis will check for signs of protein, glucose, infection, and blood. A PSA blood test is sometimes recommended based on age, life expectancy, and other medical conditions. Other lab tests may also be necessary. Your physician will discuss the tests with you before ordering them.
• Post-void residual (PVR): A test performed using ultrasound and measures urine left in the bladder after urinating.
• Urodynamic pressure flow studies: These studies evaluate bladder function in more detail for complex cases. This involves the passage of a small catheter into the bladder and the rectum to record bladder and abdominal pressures.
• Cystoscopy: Sometimes a small camera is passed into the bladder to look for abnormalities within the urethra, prostate, or bladder.

Treatment options

Treatment usually depends on the cause of your problem. Often a combination of treatments is the most effective.

• Physical therapy: Pelvic floor physical therapy helps strengthen and control the muscles. This requires evaluation by a specially trained physical therapist.
• Lifestyle modifications: Strategies include avoiding foods and drinks that irritate your bladder or urinating on a regular basis without holding it for prolonged periods of time.

An overall healthy lifestyle, including weight control, smoking cessation, balanced and healthy diet, and regular exercise often helps. Keeping a bladder diary that includes your diet, how often you urinate and what your symptoms are can help determine what irritates your bladder.

Urge urinary incontinence treatments

• Medications: Overactive bladder medications can help relax your bladder and prevent it from squeezing when it isn’t full. This allows you to hold your urine for longer periods of time.
• Bladder BOTOX® surgery: A minimally invasive procedure. BOTOX injected into the bladder helps relax your muscles and gives you more time when you feel the urge to urinate. The results last about 3–4 months.
• Nerve stimulator placement: In more severe cases, patients may have a nerve stimulator placed. This is like a pacemaker that helps regulate nerves that control your bladder.

Stress urinary incontinence treatments

• Nonsurgical: External collection devices such as a condom catheter can be placed around your penis to collect urine. It then drains into a bag attached to your leg. This can be discretely placed under your pants and can also be worn at night.
• Cunningham clamp: A padded device that clamps around your penis to apply constant pressure to keep urine from leaking out. It can only be worn for short periods of time. 
• Surgical: One surgical option is a male sling. Made of mesh, it can be implanted inside the body to support the urethra and surrounding muscles. It can help with incontinence caused by a weak urinary sphincter.
• Artificial urinary sphincter: This surgically inserted device acts like a valve — it mimics the normal activity of opening and closing the urethra and is controlled by the patient.

Benign prostate hyperplasia (BPH)

BPH is a natural enlarging of the prostate, which is very common with age. About half of men in their 50s have an enlarged prostate, and up to 90% of men over age 80 have it.* The prostate is typically the size of a walnut but can grow as large as an orange. This noncancerous condition can result in difficulties with urination, though some men may not feel any symptoms at all.

BPH symptoms may include:

• Weak stream
• Having to strain or push to start your stream
• Dribbling after you’re done urinating
• Feeling like you’re not completely finished despite having just urinated
• Urinary urgency and frequency
• Waking up at night to urinate

Contact us

We offer multiple ways to schedule with AHN urologist:

• Find an AHN urologist near you.
• Schedule online with AHN urology.
• Call one of our urology practices.

AHN urology practices

South Pittsburgh Urology
1200 Brooks Lane, Suite 220
Clairton, PA 15025
(412) 362-8677

Suburban Urologic Associates
275 Clairton Boulevard, Suite 300B
West Mifflin, PA 15122
(412) 372-6330

Triangle Urological Group
1307 Federal Street, Suite 300
Pittsburgh, PA 15212
(412) 281-1757