Urinary Incontinence Treatment Near Green Bay, WI
If you’re leaking urine, you don’t have to live with it, and care is right here in Green Bay. Dr. Ryan Stewart is a board-certified, fellowship-trained urogynecologist who diagnoses and treats urinary incontinence and other pelvic floor conditions.
Understanding urinary incontinence
Urinary incontinence means leaking urine when you don’t mean to. It’s common. Roughly 1 in 4 younger women and about half of middle-aged and older women leak at least sometimes.
It isn’t a disease on its own. It’s a symptom with a few possible causes, and it responds well to treatment.
There are three main types:
- Stress incontinence: you leak when you cough, sneeze, laugh, or exercise. The support and seal around the urethra have weakened.
- Urge incontinence: you get a sudden, strong need to go, and you leak before you reach the toilet. The bladder muscle squeezes on its own.
- Mixed incontinence: you have both. This is one of the most common patterns, and it affects up to half of women who leak.
Knowing your type matters, because the treatments differ. We’ll figure out which type (or types) you have before we make a plan.
Learn more about urinary incontinence
Why see a urogynecologist?
Many providers can talk with you about leaking. A urogynecologist focuses on it full time. Urogynecologists finish a 3-year fellowship after an OB/GYN residency, or a 2-year fellowship after a urology residency, devoted entirely to pelvic floor conditions. That extra training means more options and more experience with the harder cases.
Dr. Stewart’s approach
Dr. Stewart centers his care on teaching and shared decision-making. There’s no single “right” path that everyone has to follow in order. We’ll talk through what’s causing your leaking and what your choices are, then build a plan together that fits your life and your goals. You decide how far to go and how fast.
Your local urogynecologist
Green Bay is Dr. Stewart’s home practice, so you can get full pelvic care close to home:
- No travel required. The office is right here in Green Bay.
- The full range of care, from office visits to surgery.
- In-person and telehealth visits, scheduled around you.
Treatment options
The best treatment depends on which type of leaking you have. So the options below are grouped that way. You don’t have to try them in any set order. We’ll pick based on what bothers you most and what you want to try.
Some treatments help no matter the type:
- Pelvic floor physical therapy. This is more than Kegels. A therapist helps you build strength, learn to relax muscles that are too tight, improve coordination and timing, and work the muscles around the pelvis (hips, buttocks, thighs, and core). Breathing and posture are part of it too. We have pelvic floor PTs in the office, so this care is close by.
- Everyday changes. Bladder training, adjusting how much and what you drink, and managing constipation can all reduce leaking.
For stress incontinence (leaking with coughs, sneezes, and activity)
- A pessary. This is a small, removable support you wear inside the vagina to back up the urethra during activity.
- Urethral bulking. We inject a soft material around the urethra to help it seal. It’s done in the office, and the effect can last several years (one agent has 7-year data).
- A midurethral sling. This is the most common surgery for stress incontinence, with strong long-term data. In studies, the median cure rate is about 84% at one year. We’ll go over the benefits and risks so you know what to expect.
For urge incontinence and overactive bladder (sudden urges and leaking)
- Bladder training and pelvic floor PT, which work well as a first step.
- Medications that calm the bladder muscle. We choose these carefully, and we generally avoid one older class (anticholinergics) in women 55 and older because of effects on memory and thinking. A different class (beta-3 agonists) is often a better fit.
- Bladder Botox. A small amount relaxes the bladder muscle. It usually lasts 6 to 9 months, then is repeated.
- Nerve treatments (neuromodulation). Tibial nerve stimulation works through a nerve near the ankle. Sacral neuromodulation uses a small implanted device; its battery lasts about 10 to 15 years.
For mixed incontinence (both types)
When you have both, we treat the type that bothers you most first. If the stress part leads and you have surgery for it, the urge symptoms can flare for a while, so we often pair surgery with pelvic floor therapy to keep urgency in check.
Dr. Stewart will walk you through the choices that fit your type and your goals so you can decide together.
References
- ACOG Committee on Practice Bulletins—Gynecology, American Urogynecologic Society. 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
- Kobashi KC, Albo ME, Dmochowski RR, et al. Surgical Treatment of Female Stress Urinary Incontinence: AUA/SUFU Guideline. The Journal of Urology. 2017. doi:10.1016/j.juro.2017.06.061
- Fleischmann N, Chughtai B, Plair A, et al. Urethral Bulking. Urogynecology. 2024. doi:10.1097/SPV.0000000000001548
- Lightner DJ, Gomelsky A, Souter L, Vasavada SP. Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment 2019. The Journal of Urology. 2019. doi:10.1097/JU.0000000000000309
- Richter HE, Albo ME, Zyczynski HM, et al. Retropubic versus Transobturator Midurethral Slings for Stress Incontinence. New England Journal of Medicine. 2010. doi:10.1056/NEJMoa0912658
- Peters KM, Carrico DJ, Perez-Marrero RA, et al. Randomized Trial of Percutaneous Tibial Nerve Stimulation Versus Sham Efficacy in the Treatment of Overactive Bladder Syndrome: Results From the SUmiT Trial. The Journal of Urology. 2010. doi:10.1016/j.juro.2009.12.036
- 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
Telehealth consultations available — start your care from home in Green Bay.
- 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