Urinary incontinence treatment near Appleton, WI
If you live in Appleton or elsewhere in the Fox Cities and you’re leaking urine, Dr. Ryan Stewart is a board-certified, fellowship-trained urogynecologist in Green Bay, about 40 minutes up the road. Telehealth visits are available for consultations and follow-ups, so not every visit means a drive.
Types of urinary incontinence
Bladder leakage is common. Estimates run from about 1 in 4 younger women to roughly half of women in midlife and after menopause, and higher still in older women. It isn’t a disease on its own. It’s a symptom, and it responds well to treatment.
The main types:
- Stress incontinence: you leak when you cough, sneeze, laugh, lift, or exercise. The support and seal around the urethra have weakened.
- Urge incontinence: you get a sudden, strong need to go and leak before you reach the toilet. The bladder muscle squeezes on its own (overactive bladder).
- Mixed incontinence: you have both. This is one of the most common patterns, affecting up to half of women who leak.
The type matters because the treatments differ, so we sort that out first.
Learn more about urinary incontinence
Why see a urogynecologist?
Many clinicians can start treatment for leaking. A urogynecologist works on pelvic floor problems full time. Urogynecologists complete either a 3-year fellowship after an OB/GYN residency or a 2-year fellowship after a urology residency, devoted to pelvic floor conditions. That training covers the full range of options, from office treatments to surgery, and the harder cases, like leaking that came back after an earlier repair.
Dr. Stewart’s perspective
“Incontinence is one of the most common things I treat, and one of the most rewarding, because the treatments we have today work well. Most women improve a lot, and many stop leaking altogether.”
Treatment options
You don’t have to work through these in a fixed order. We’ll pick based on your type of leaking, what bothers you most, and what you’re willing to try.
Some treatments help with any type:
- Pelvic floor physical therapy. We have pelvic floor therapists in our office and work with dozens more throughout northeast Wisconsin and Michigan’s Upper Peninsula, so you may be able to find one closer to Appleton.
- Everyday changes: bladder training, adjusting how much and what you drink, and managing constipation.
For stress incontinence (leaking with activity)
- Pessary: a small, removable device worn in the vagina to support the urethra during activity.
- Urethral bulking: an office procedure that injects a soft gel around the urethra to help it seal. Results with the agent I use have held up for at least 7 years in follow-up studies.
- Midurethral sling: a minimally invasive outpatient surgery and the most common operation for stress leakage. Studies report improvement in roughly half to 90% of women, depending on how success is measured, with mesh complications under 5%.
For urge incontinence and overactive bladder (sudden urgency and leaking)
- Bladder training and pelvic floor therapy to calm urgency.
- Medications that relax the bladder muscle. One older class (anticholinergics) has been linked to memory problems with long-term use, so I often reach for a newer class (beta-3 agonists) instead, especially for older women.
- Bladder Botox: an office procedure that relaxes the bladder muscle. It usually lasts 6 to 9 months, then is repeated.
- Sacral neuromodulation: a small implanted device, sometimes called a bladder pacemaker, that adjusts the nerve signals to the bladder. The battery lasts 10 to 15 years.
- Tibial neuromodulation: stimulation of a nerve near the ankle. I offer a small implanted tibial device, placed under local anesthesia, that then runs at home. The weekly-office-visit version (PTNS) is offered by other clinics.
For mixed incontinence (both types)
We treat whichever type bothers you most first. If that’s the stress leakage and you choose a sling, urge symptoms can flare for a while after surgery, so we often pair surgery with pelvic floor therapy.
I’ll go through the options that fit your type and your goals, and we’ll decide together.
Getting here from Appleton
- About a 40-minute drive to Green Bay
- Telehealth available for consultations and follow-ups
- Most major insurance plans accepted, including Medicare and Medicaid
- No referral necessary
References
- ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society, Kenton KS, Smilen SW. Urinary Incontinence in Women (ACOG Practice Bulletin No. 155). Obstetrics & Gynecology. 2015. doi:10.1097/AOG.0000000000001148
- Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary Incontinence in Women: A Review. JAMA. 2017. doi:10.1001/jama.2017.12137
- Richter HE, Burgio KL, Brubaker L, et al. A Trial of Continence Pessary vs. Behavioral Therapy vs. Combined Therapy for Stress Incontinence. Obstetrics & Gynecology. 2010. doi:10.1097/AOG.0b013e3181d055d4
- Fleischmann N, Chughtai B, Plair A, et al. Urethral Bulking. Urogynecology. 2024. doi:10.1097/SPV.0000000000001548
- AUGS Guidelines Committee, Thomas TN, Walters MD. Clinical Consensus Statement: Association of Anticholinergic Medication Use and Cognition in Women With Overactive Bladder. Female Pelvic Medicine & Reconstructive Surgery. 2021. doi:10.1097/SPV.0000000000001008
- White N, Iglesia CB. Overactive Bladder. Obstetrics and Gynecology Clinics of North America. 2016. doi:10.1016/j.ogc.2015.10.002
- Lee U, Xavier K, Carey J, et al. Implantable Tibial Neuromodulation Therapy Improves Symptoms of Urge Urinary Incontinence From the TITAN 2 Pivotal Study. The Journal of Urology. 2026. doi:10.1097/JU.0000000000004958
- Sung VW, Borello-France D, Newman DK, et al. Effect of Behavioral and Pelvic Floor Muscle Therapy Combined With Surgery vs Surgery Alone on Incontinence Symptoms Among Women With Mixed Urinary Incontinence: The ESTEEM Randomized Clinical Trial. JAMA. 2019. doi:10.1001/jama.2019.12467
Schedule Your Appointment
40 minutes from Appleton, WI
Telehealth consultations available — start your care from home in Appleton.
- No referral necessary
- Now accepting new patients
- Most Wisconsin insurance plans accepted, including Anthem, Dean, Quartz, Network Health, and UnitedHealthcare.
- In-person and virtual appointments available
Schedule through Aurora BayCare
Or call (920) 288-8510 to book by phone.