Urinary Incontinence and Overactive Bladder Treatment in Green Bay, WI

If you are planning your day around bathroom locations, waking up multiple times a night, wearing pads you never thought you would need, or avoiding activities you love because you are worried about leakage, you are not alone. Urinary incontinence and overactive bladder affect millions of men and women, and most people wait far too long before seeking help.

At Urology Associates of Green Bay, we treat the full spectrum of urinary incontinence and overactive bladder in both men and women. Our approach starts with understanding your specific type of incontinence and its underlying cause, then building a treatment plan that makes sense for your symptoms, your goals, and your life. We offer everything from behavioral strategies and pelvic floor therapy to in office Botox, nerve stimulation implants, and surgical correction.

Not all incontinence is the same, and the right treatment depends entirely on getting the diagnosis right. Your history is the most important part of your evaluation.

Overactive bladder and urge incontinence involve a sudden, intense urge to urinate that is difficult to control, often followed by involuntary leakage. You may find yourself going to the bathroom far more frequently than you should, waking up multiple times at night, and occasionally not making it in time. This is driven by involuntary contractions of the bladder muscle and is one of the most common and most treatable forms of incontinence.

Stress incontinence is leakage that occurs with physical activity: coughing, sneezing, laughing, lifting, running, or exercise. It is caused by weakness in the pelvic floor muscles or the urethral sphincter, and it is especially common in women after childbirth and in men after prostate surgery or radiation. The bladder itself is functioning normally, but the support system that keeps the urethra closed under pressure is not doing its job.

Many people have mixed incontinence, meaning they experience both urge and stress components. Others have incontinence related to incomplete bladder emptying, neurologic conditions, or medication side effects. Getting the diagnosis right is the critical first step, because treating the wrong type of incontinence will not help.

For most patients, we start with the least invasive options and build from there. Many people see meaningful improvement without ever needing a procedure.

Behavioral strategies include timed voiding, bladder retraining, fluid management, and identifying and reducing bladder irritants such as caffeine, alcohol, and artificial sweeteners. These changes sound simple, but they can produce real results, particularly for overactive bladder.

Pelvic floor physical therapy is one of the most effective and underutilized treatments for both urge and stress incontinence. A trained pelvic floor therapist can help you strengthen and coordinate the muscles that support bladder control. We work closely with physical therapy partners in the area and refer frequently. For many patients, especially women with stress incontinence and men recovering from prostate surgery, pelvic floor therapy is a game changer.

Medications for overactive bladder work by calming the bladder muscle and reducing the frequency and urgency of contractions. Several classes of medication are available, and we match the choice to your symptoms, your tolerance for side effects, and your other medications. Medication works well for many patients, though some find the side effects (dry mouth, constipation, and in older patients, cognitive effects) limit their use long term.

For patients with overactive bladder or urge incontinence who do not get adequate relief from behavioral strategies and medications, Botox (onabotulinumtoxinA) injected directly into the bladder wall is an excellent next step. It works by relaxing the overactive bladder muscle, reducing urgency, frequency, and leakage episodes.

The procedure is performed in our office and takes about one minute. We use a modern injection technique that requires very few needle passes, sometimes as few as one. Most patients describe the sensation as a tiny bee sting. There is no sedation required, no recovery time, and you go home immediately afterward.

A single treatment typically lasts six to twelve months. When the effects begin to wear off, the procedure can be repeated. Many patients settle into a routine of one or two treatments per year and find it far preferable to taking a daily medication. Botox is covered by most insurance plans for overactive bladder after a trial of oral medication.

For patients with overactive bladder or urge incontinence who have not responded to medications or Botox, or who prefer a long term solution that does not require repeated treatments, sacral neuromodulation is a proven option. Think of it as a pacemaker for the bladder.

Sacral neuromodulation works by delivering gentle electrical stimulation to the sacral nerves that control bladder function. This modulates the signals between the bladder and the brain, reducing the involuntary contractions that cause urgency and leakage. We offer both the Medtronic InterStim system and the AltaViva device, and help you determine which is the best fit based on your anatomy, lifestyle, and preferences.

The procedure is done in two stages. First, a trial lead is placed and connected to an external device that you wear for a test period, typically one to two weeks. This allows you to experience the therapy and confirm that it works before committing to a permanent implant. If the trial is successful, the permanent device is implanted in a short outpatient procedure. The device is small, fully implantable, and rechargeable.

Stress incontinence requires a different approach than overactive bladder because the problem is structural rather than muscular overactivity. When pelvic floor therapy alone is not enough, we offer several procedural options.

Bulkamid is a minimally invasive, in office injectable treatment that adds bulk around the urethra to improve its ability to close under pressure. It is a good option for women with mild to moderate stress incontinence who want improvement without a more invasive procedure, and for men with mild leakage after prostate surgery. The procedure is quick, well tolerated, and can be repeated if needed.

Sling procedures are the gold standard surgical treatment for stress incontinence in both men and women. In women, a midurethral sling provides support beneath the urethra using a small piece of mesh placed through a minimally invasive approach. In men, the male sling provides similar support and is an excellent option for moderate post prostatectomy incontinence. Sling surgery is an outpatient procedure with a relatively quick recovery and high success rates.

The artificial urinary sphincter (AUS) is reserved for men with more severe incontinence, particularly after prostate cancer treatment. It is an implantable device that restores continence by providing a cuff around the urethra that the patient controls with a small pump in the scrotum. The AUS has excellent long term results and is the gold standard for significant male stress incontinence.

One of the advantages of seeing a urology practice with the full range of treatment options is that we are not limited to one approach. A clinic that only offers medication can only offer medication. A clinic that only does a particular procedure tends to see every patient as a candidate for that procedure. At Urology Associates, we match the treatment to you, not the other way around. We start conservative and escalate only when needed, and we are honest about realistic expectations for each option.