Ghatkopar (East), Mumbai)
Urinary Incontinence
Leaking urine when you laugh, cough, or sneeze. Rushing to the bathroom and not always making it. Avoiding exercise, social gatherings, or long journeys out of fear of an accident. Urinary incontinence is one of the most underreported conditions in medicine - yet it affects millions of men and women across all age groups and is highly treatable.
At Shree Hospitals, our urology team offers specialised urinary incontinence treatment in Mumbai, combining lifestyle interventions, pelvic floor rehabilitation, medications, and surgical procedures - tailored to the type and severity of leakage.
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Our Approach
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Our Approach In Managing Urinary Incontinence
Leaking urine is not something you have to live with.
Urinary incontinence is classified by type, and treatment must match the type precisely. Stress incontinence, urgency incontinence, overflow incontinence, and mixed incontinence each have different mechanisms, different investigations, and different solutions.
- Incontinence Type Classification & Urodynamic Assessment
Correct diagnosis precedes all treatment decisions:
- Clinical history - type, frequency, volume, and triggers of leakage; pad usage; fluid intake and voiding diary
- Stress test - cough or Valsalva during a full bladder to confirm stress urinary incontinence (SUI)
- Urodynamic study - the gold standard for complex or mixed incontinence; measures bladder pressure, capacity, compliance, and detrusor overactivity
- Cystoscopy - for incontinence associated with haematuria, recurrent UTI, or suspected fistula
- Pelvic floor ultrasound - assesses levator ani integrity and urethral mobility in women
- Conservative Management - First Line for All Types
Conservative therapy is always attempted before surgery:
- Pelvic floor rehabilitation - supervised physiotherapy-led Kegel exercise programme; effective in 60–70% of mild-to-moderate SUI
- Bladder training - timed voiding schedule with progressive deferral intervals for urgency incontinence
- Fluid management - reducing caffeine, alcohol, and fluid timing rather than restricting total intake
- Weight reduction - every 5kg of weight loss reduces stress incontinence severity by approximately 50%
- Medical Therapy for Overactive Bladder
For urgency incontinence and overactive bladder (OAB):
- Anticholinergics (solifenacin, oxybutynin, tolterodine) - reduce detrusor overactivity; first-line pharmacotherapy
- Mirabegron (beta-3 agonist) - alternative for patients who cannot tolerate anticholinergic side effects (dry mouth, constipation)
- Bladder control treatment combination therapy for refractory OAB - mirabegron plus low-dose anticholinergic
- Regular follow-up at 4 and 12 weeks to assess response and adjust dosing
- Botulinum Toxin (Botox) Bladder Injections
For urgency incontinence refractory to medication:
- 100 units of onabotulinum toxin injected into the detrusor muscle under cystoscopic guidance
- Day-care procedure under local anaesthetic - takes 15–20 minutes
- Effect lasts 6–9 months; repeat injection as required
- Highly effective - >70% of patients achieve significant reduction in urgency episodes
- Midurethral Sling Surgery for Stress Incontinence
The gold-standard surgical treatment for women with SUI:
- Midurethral sling surgery - a small synthetic mesh tape passed beneath the midurethra to provide support
- Retropubic (TVT) or transobturator (TOT) approach based on urodynamic and anatomical assessment
- Day-care or overnight procedure; catheter removed before discharge in most cases
- Success rates of 85–90% at 5 years - the most evidence-supported SUI procedure available
- Male Incontinence Surgery
Post-prostatectomy stress incontinence requires a different approach:
- Pelvic floor physiotherapy as first-line for 6–12 months post-prostatectomy
- Male sling (AdVance or AdVance XP) for mild-to-moderate post-prostatectomy incontinence
- Artificial Urinary Sphincter (AUS) - the gold standard for moderate-to-severe male stress incontinence surgery Mumbai; cuff placed around the urethra, activated by a scrotal pump
- AUS success rates exceed 85% for achieving social continence (0–1 pads per day)
- Neuromodulation - Sacral Nerve Stimulation (SNS)
For urgency incontinence and OAB refractory to medication and Botox:
- Overactive bladder specialist in Mumbai India - sacral neuromodulation (Interstim) implanted under the skin
- Stage 1: External test stimulation for 2 weeks to confirm response
- Stage 2: Permanent device implanted if >50% improvement during the test phase
- Effective for both urgency incontinence and urinary retention from neurological causes
How To Identify Urinary Incontinence?
Incontinence is categorised by when and why leakage occurs:
Stress Urinary Incontinence (SUI):
- Leakage triggered by physical activity - coughing, sneezing, laughing, running, lifting
- No prior urgency - the leak happens with increased intra-abdominal pressure
- Common in women after childbirth; men after prostate surgery
- Severity ranges from occasional drops to significant volumes with minimal exertion
Urgency Urinary Incontinence (UUI) / Overactive Bladder:
- Sudden, intense urge to urinate that cannot be deferred - followed by leakage before reaching the toilet
- Frequency - urinating more than 8 times per day
- Bladder control treatment indicators - nocturia (waking 2+ times per night to void)
- May occur without obvious trigger or be triggered by running water, cold temperature, or key-in-door syndrome
Overflow Incontinence:
- Continuous dribbling or leakage from a bladder that never fully empties
- Associated with incomplete bladder emptying (high post-void residual)
- Common in men with severe BPH, or patients with diabetic or neurological bladder
Treatments For Urinary Incontinence At Shree Hospitals
Pelvic Floor Physiotherapy & Bladder Training
Supervised physiotherapy programme targeting pelvic floor muscle strength and bladder control - effective for 60–70% of mild-to-moderate stress and urgency incontinence cases as first-line treatment.
Anticholinergic / Mirabegron Medical Therapy
Oral medication for overactive bladder and urgency incontinence - reduces detrusor overactivity, increases bladder capacity, and reduces urgency episodes. Adjusted at 4-week follow-up.
Botulinum Toxin Bladder Injections (Botox)
Cystoscopically guided injection into the detrusor muscle - provides 6–9 months of urgency incontinence control; highly effective for medication-refractory OAB.
Midurethral Sling (TVT / TOT)
Gold-standard surgical treatment for female stress incontinence - synthetic tape supports the urethra and prevents leakage with physical activity. 85–90% success rate at 5 years.
Top Urologists in Mumbai
Dr. Shyam Mohan
Robotic Urological Surgery, Uro-Oncology
Dr. Alap Mehendale
Urologist, Andrologist, Kidney Transplant Surgeon
For Appointment/Query
1800-268-4000
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Important FAQs: Urinary Incontinence
Is urinary incontinence a normal part of ageing or childbirth?
Urinary incontinence is common - but it is not normal or inevitable, and it should never be accepted as something to simply manage with pads. It has identifiable causes and highly effective treatments. Both post-partum and age-related incontinence respond well to pelvic floor rehabilitation, medication, or minimally invasive surgery. Many women suffer unnecessarily for years without knowing that a day-care procedure could make them completely dry.
What is the difference between stress and urgency incontinence?
Stress incontinence leaks when physical pressure is applied to the bladder - coughing, laughing, sneezing, or exercise. Urgency incontinence involves a sudden, uncontrollable urge to urinate that results in leakage before reaching the toilet. Many patients have mixed incontinence - both types simultaneously. Treatment differs: SUI responds best to midurethral sling surgery; urgency incontinence is treated with bladder training, medication, or Botox injections.
How effective is the midurethral sling for stress incontinence?
Midurethral sling surgery (TVT or TOT) has the strongest evidence base of any procedure for female stress urinary incontinence. Published success rates at 5 years are 85–90%, and long-term data at 10–15 years confirms durable results. The procedure takes approximately 20–30 minutes, is performed under regional or general anaesthesia, and most patients go home the same day or the following morning.
Are there non-surgical treatments for urgency incontinence?
Yes – and we always try these first. Bladder training, fluid management, and bladder control treatment with anticholinergics or mirabegron are effective for many patients with overactive bladder. For those not responding to medication, Botox bladder injections provide 6–9 months of control per treatment session. Sacral nerve stimulation (neuromodulation) is a longer-term implantable option for refractory urgency incontinence. Surgery is reserved for cases where all other approaches have been optimised.
Can men develop urinary incontinence and how is it treated?
Yes - urinary incontinence in men most commonly occurs after prostate surgery (radical prostatectomy) for prostate cancer. Most men improve significantly with pelvic floor rehabilitation in the first 6–12 months post-surgery. For those with persistent moderate-to-severe leakage, a male sling or Artificial Urinary Sphincter (AUS) is highly effective. Our overactive bladder specialist in Mumbai India team manages both male and female incontinence with equal expertise.
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