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Welcome to Fifth Avenue Urology, the practice of Dr. Yaniv M. Larish. We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

Dr. Larish served as the former chief resident of Urology at Lenox Hill Hospital. Drs. Larish is focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. At Fifth Avenue Urology, we view the ability to practice medicine as a privilege, not a right. They treat their patients with respect, professionalism and compassion.

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Yaniv M. Larish, M.D.

dr-yaniv-larish-fifth-avenue-urology2 Dr. Larish is a urologist and surgeon treating women and men with a variety of urological conditions. His expertise is in treating complex kidney stones, enlarged prostates (BPH), incontinence, erectile dysfunction, infertility, and urological oncology (prostate, bladder, kidney, and adrenal cancers). He is an expert in general urology and is often consulted for second opinions.

Dr. Larish’s dedication to patients and their families drives his belief in prompt evaluation and care. He treats all his patients like family. As such, same day appointments are available for urgent issues and house calls can be made in select cases.

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Blog Posts are Below:

Category Archives: Urinary Incontinence in men

Overactive Bladder & Urge Incontinence

Overactive bladder is a common condition that affects millions of people every year in the US and causes changes in their lifestyle. The changes in their lives can be devastating, depending on the severity of the condition. An overactive bladder or OAB causes the patient to feel sudden and frequent urges to urinate. The urge to urinate can come at night and several times at that. It can be quite disturbing and interrupt sleep, leading to insomnia, anxiety, and frustration.

Overactive Bladder & Urge Incontinence
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Like OAB, patients with urge incontinence feel sudden and frequent urges to urinate during the day and night. However, the main difference is that in urge incontinence health issues, patients leak urine more frequently than those affected by OAB. The overall impact on the lifestyle can be devastating as patients avoid social interactions and feel awkward discussing their reasons for frequent trips to the restroom.

Urge Incontinence and Overactive Bladder: Symptoms

In case you have urge incontinence and/or an overactive bladder health condition, you must know the early symptoms that are common in both. Identifying symptoms at an early stage can help you get the required treatments on time for fast recovery:

Difficulty controlling the urge to urinate
Frequent urges to urinate even when you haven’t had water or any other liquid for a few hours
Waking up at night more than once due to an urge to urinate
Unintentional urine loss, whether you have an urge to urinate or not
Urinating more than eight times during a 24-hour period

Most of the time, patients with urge incontinence and overactive bladder end up leaking urine before reaching the restroom. The unexpected urge to urinate is among the most common symptoms for both types of health issues.

However, it can be difficult to go by a daily routine with such issues. Therefore, most people try to get the best treatments to help resolve the issues. Generally, oral medications work wonders and help patients deal with symptoms. But, when oral medications fail, patients have to discuss the possible treatment options to solve the urge incontinence and overactive bladder issues.

Fortunately, two treatment methods have been gaining quite some attention from the patients. Expert urologists suggest that sacral neuromodulation and bladder botox injections can help solve the bladder and pelvic muscle-weakening while also resolving several symptoms. Let’s take a detailed look at both treatment options below.

Sacral Neuromodulation (aka Sacral Nerve Stimulation)

Sacral Neuromodulation or Sacral Nerve Stimulation, aka SNN, is a therapy that’s aimed at solving different bowel and bladder health problems. It’s worth mentioning that SNN isn’t for all patients struggling with urge incontinence or overactive bladder conditions due to several health factors. Despite that, it’s one of the best life-changing treatment options for such affected people. Consult the right urologist to discuss your eligibility.

SNN therapy involves the use of electrical implants that augment the communication between the bowel/bladder and brain to ensure effective control over urination. It’s still in diagnostic trials, and expert urologists are still considering massive applications across the healthcare industry. However, several reputable urologists suggest that SNN can help improve various symptoms.

Is It Right for You?

SNN therapy is possible when lifestyle changes, oral medications, and other treatment methods fail to improve urge incontinence and overactive bladder. It’s a recommended procedure by expert urologists once conservative treatments don’t work. A specialist urologist will assess your eligibility and qualify you for the treatment procedure.

Bladder Botox Injections

Botox injections aren’t only for face wrinkles. They can help relax and control bladder muscles to help in relieving overactive bladder and urge incontinence symptoms. It’s also an important treatment method by expert urologists once conservative treatments yield little to no results.

Botox refers to a powerful protein that’s natural bacteria. It has natural paralyzing effects on muscles. Hence, it’s helpful in relaxing contracting bladder muscles that are causing urge incontinence and unintentional urine leakage/ loss.

What’s the Procedure?

Overactive Bladder Botox Injections | Urge Incontinence Urologist

From severe neurological diseases to spastic bladders, Botox injections have a powerful drug that helps counter countless symptoms to improve overall health conditions. The Botox drug lasts inside the body for nearly 6-8 months before a re-injection is needed to keep the effects persistent. Surprisingly, there’re no clear limitations to using this treatment method for solving urge incontinence and overactive bladder issues.

A skilled urologist will use their surgical skills to insert the injection at the chosen site on the body (near the bladder). The entire procedure is quite complicated and hence, requires an experienced urologist for effective results and recovery.

Overactive Bladder & Urge Incontinence: Conclusion

Do you know that there are top urologists in NYC offering bladder botox injection therapies and sacral neuromodulation treatments? Well, at Fifth Avenue Urology. Dr. Yaniv Larish and Dr. Leonard Glickman offer well tried and practiced urological treatment services. Most urology patients refer these doctors to their friends and families with respective urological health issues. If you’re suffering from urge incontinence and/or an overactive bladder, both doctors can help you find the required treatment.

From botox injections to sacral neuromodulation, the doctors at Fifth Avenue Urology have immense experience in solving urge incontinence and overactive bladder symptoms. Give us a call at 212-675-3186 to set an appointment at our institute for urological health conditions and treatments.

Urinary Incontinence in Men

Urinary incontinence in men can occur for various reasons. In most cases, this is a treatable problem and one that men should feel they can speak freely about to their doctors. Urinary incontinence, often called UI for short, is the accidental leaking of urine. It can occur in both men and women and it can occur at any age. In men, it is less common and becomes more common as men age. However, not all men will suffer from this condition as they get older.

What Is the Cause of Urinary Incontinence in Men?

In order for doctors to provide treatment for urinary incontinence in men, it becomes important to understand the underlying cause of it. Some of the potential causes of this condition include:

Stress: Stress incontinences is one of the most common forms of this condition. In it, involuntary loss of urine occurs at specific times such as when a man sneezes, during lifting, or when he coughs. This creates pressure in the abdomen that leads to pressure on the bladder and the release of urine.

Overflow: Overflow incontinence is another type of incontinence in men. In this condition, there is a constant dribbling of urine. This also usually involves frequent needs to urinate with small amounts.

Urge: A third form is urge incontinence. In this instance, men will have an overwhelming urge to urinate. He usually cannot halt the process from occurring.

What Is the Cause of Urinary Incontinence in Men?

urinary incontinence There are many factors that can contribute to this condition. Generally, it is a failure of the urinary system that relies on muscles and nerves working together to hold urine in the bladder until the appropriate time for it to be released. Nerve problems are the most common cause. This can be brought on by men who have suffered stroke, multiple sclerosis, or Parkinson’s disease. It can also be brought on by prostate problems including BPH or other conditions in which the prostate becomes enlarged.

For men who suffer from this condition, it becomes important to speak to their doctor about it. Some may feel overwhelmed or embarrassed by it, but there are treatment options available to many men. To learn more about this condition and whether or not you have it, contact our experienced urologist in New York City to schedule a full consultation and exam to discuss your options.

Urinary Incontinence in Men

doctor in nyc for Urinary incontinence in men p02 Urine is made as the blood is filtered through the kidneys. The urine then travels through thin tubes called the ureters, to the urinary bladder. The tube known as the urethra travels from the bladder, where it passes through the prostate gland and the penis to allow the release of urine outside of the body. Urinary incontinence refers to involuntary leakage of urine.

doctor in nyc for Urinary incontinence in men p01 The urethra is surrounded by muscular tissue known as the urinary sphincter. The bladder fills with urine, and nerves in the bladder signal the sphincter to remain constricted, as the bladder stays relaxed. When your bladder is full, the nerves in the bladder are triggered to cause the muscles of the bladder to contract, and the urethra relaxes at the same time. Urine then flows from the bladder into the urethra, and you are able to void voluntarily because of the relaxation of the urethral sphincter. Urinary incontinence is the result of a problem somewhere in this pathway. An urologist is a specialist in problems like urinary incontinence, and if you suffer from involuntary leakage of urine, you should consult an expert urologist for an evaluation of your condition. If you are in the New York City area, Dr. Melman is one of the top urologists in the United States, and is available for consultation by appointment.

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There are different types of urinary incontinence, and they have different symptoms. If you leak urine when you cough, sneeze, laugh, or perform any action that puts pressure or stress on your bladder, this is known as stress incontinence. If you have a strong urge to urinate but can’t make it to the bathroom in time, you may have urge incontinence, which can occur even when your bladder is not full. Stress incontinence may be caused by removal of the prostate gland for prostate cancer or an enlarged prostate gland. Usually behavioral methods, including exercises to strengthen the pelvic floor, are the first attempt at treatment, and surgery may be considered if other methods fail. A bulbourethral sling is currently being studied as a potential treatment that works by supporting the urethra with the sling which is then attached to muscle or to the public bone, elevating the urethra and strengthening urethral resistance to abdominal pressure.

Another type of urinary incontinence is overflow incontinence. This occurs because your bladder doesn’t empty correctly and leaks as a result, after urination. Sometimes your bladder muscles may be weak, and this may be the reason that your bladder doesn’t empty correctly. Your urethra may be blocked by scar tissue or an enlarged prostate gland, which will also prevent you from emptying your bladder. If your overflow incontinence is the result of an enlarged prostate gland, an urologist will be able to treat this condition surgically.

If your sphincter muscle no longer works, you may be leaking urine continuously, which is known as total incontinence. A urologist may be able to surgically correct this condition by implanting an artificial sphincter, made of silicone rubber that fits around the urethra, and which can be inflated or deflated with a pump to control urination.

Incontinence may be short-term, and related to urinary tract infections, prostatitis, or even constipation. Your urologist can help you make the correct diagnosis and when incontinence is due to one of these causes, it usually resolves after treatment.

Pharmacologic treatment of urinary incontinence is always attempted before surgery, if a treatable condition is identified. There are medications that increase the bladder capacity by relaxing the muscles of the bladder wall, and other medications, including duloxetine, an antidepressant, changes how the brain interacts with the bladder, although the mechanism is not entirely understood. Another antidepressant medication, Imipramine, causes the bladder muscle to relax and at the same time causes the muscles at the bladder neck to contract, preventing urge incontinence.

doctor in nyc for Urinary incontinence in men p04 If you suffer from urinary incontinence, you should consult Dr. Melman in New York City, and take advantage of his years of experience and knowledge, which have made him one of the top urologists in the United States. Contact Dr. Melman today to start your treatment for male urinary incontinence.