Urinary Incontinence
Urinary incontinence — the involuntary leakage of urine — is common and treatable, whether it happens with coughing and exercise (stress incontinence), with sudden urges (urge incontinence), or both (mixed incontinence). IM Care Family NP evaluates and manages urinary incontinence via telehealth for New York State residents.
Common Symptoms
Leakage with coughing, sneezing, laughing, or exercise (stress)
Leakage with a sudden, strong urge to urinate (urge)
A combination of both patterns (mixed)
Needing to wear pads or change habits to manage leakage
What May Contribute
Pelvic floor muscle weakness, often related to childbirth or aging
Hormonal changes around menopause
Bladder muscle overactivity
Chronic coughing, constipation, or high-impact activity
Prior pelvic surgery
This is general information, not a diagnosis — many different conditions can cause similar symptoms.
How We Evaluate
Detailed history to determine which type(s) of incontinence are present
Urinalysis to rule out infection
Bladder-diary review
Referral for pelvic floor physical therapy assessment, a pelvic exam, or urodynamic testing when indicated
Treatment Options We May Discuss
Pelvic floor physical therapy (often first-line)
Bladder training and lifestyle modification
Vaginal estrogen for appropriate candidates
Medications for urge-predominant symptoms
Referral to urogynecology or urology for procedural options (e.g., pessary, sling surgery) when conservative measures aren't enough
Can This Be Managed by Telehealth?
The initial history, symptom classification, and referral to pelvic floor physical therapy can typically be done by telehealth. Confirming the exact type of incontinence sometimes benefits from a referral for a pelvic exam, and procedural treatments require referral to a specialist.
Frequently Asked Questions
Real questions patients ask us about this condition.
What's the difference between stress and urge incontinence?
Stress incontinence is leakage triggered by physical exertion like coughing or exercise, while urge incontinence is leakage that follows a sudden, strong urge to urinate. Many people have a mix of both.
Can pelvic floor physical therapy really help incontinence?
For many patients, yes — pelvic floor physical therapy is considered a first-line, evidence-based treatment for stress and mixed incontinence.
Is incontinence just a normal part of aging I have to live with?
Incontinence is common, especially with age and after childbirth, but it isn't something you have to simply accept — most patients have effective options to reduce or resolve symptoms.
Can incontinence be evaluated over a telehealth visit?
Yes, an initial evaluation and treatment plan can often start by telehealth, though some patients benefit from a referral for a physical exam to confirm the type and severity.
When to Seek Urgent Care
Contact urgent care, an emergency room, or call 911 right away if you experience:
• Sudden new incontinence with weakness or numbness
• Inability to urinate at all
• Blood in the urine
• Incontinence following a fall or injury
Ready to Talk to a Provider?
Schedule a consultation with Inga Melnikova, DNP, FNP-C to discuss your symptoms and next steps.
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