Incontinence Treatment Options in San Antonio

Bladder leakage can be frustrating, uncomfortable, and difficult to talk about. Urinary incontinence affects many adults, but it is often very treatable with the right care.

Our specialists provide incontinence treatment options in San Antonio for men and women experiencing bladder leakage. After identifying the cause of your symptoms, we develop a treatment plan to help improve bladder control and reduce leakage.

The bladder stores urine until you are ready to urinate. As it fills, nerves send signals to your brain. When it is time to empty the bladder, your brain tells the bladder muscle to tighten while the urethra relaxes.

If these signals stop working together, or if the pelvic floor muscles become weak, urine leakage can happen.

Understanding your type of incontinence helps determine the right treatment.

Urge Incontinence (Overactive Bladder)

Urge incontinence causes a sudden need to urinate that is hard to control. Leakage can happen before you reach the bathroom.

Common symptoms include:

• Frequent bathroom trips
• Waking up at night to urinate
• Sudden leakage with little warning

Stress Incontinence

Stress incontinence happens when pressure on the bladder causes leakage. This often occurs when the pelvic floor muscles become weak.

Leakage may occur when you:

• Cough
• Sneeze
• Laugh
• Lift something heavy
• Exercise

Mixed Incontinence

Mixed incontinence means you have both urge and stress symptoms. Treatment usually focuses on the symptoms that bother you most.

Treatment usually begins with simple approaches and moves to more advanced options if needed.

Our San Antonio urologists help patients choose the treatment that fits their symptoms and lifestyle.

Bladder Training

Bladder training helps increase the time between bathroom visits. Instead of going “just in case,” you follow a schedule and slowly increase the time between trips.

Over time, this helps the bladder send better signals to the brain.

Lifestyle and Behavioral Changes

Small changes in daily habits can improve bladder control.

These changes may include:

• Managing fluids by spreading drinks throughout the day
• Limiting bladder irritants such as caffeine and alcohol
• Preventing constipation, which can increase pressure on the bladder
• Weight loss, when appropriate, to reduce pressure on the pelvic floor

Pelvic Floor Physical Therapy

Pelvic floor therapy strengthens the muscles that support the bladder and urethra.

A trained therapist evaluates muscle strength, coordination, and endurance. Therapy can help improve symptoms over time.

Pelvic floor therapy is often recommended for:

• Stress incontinence
• Postpartum leakage
• Mild urge symptoms
• Men recovering from prostate surgery

Medications

Some medications help relax the bladder muscle and reduce sudden urges to urinate.

Two common types include:

• Anticholinergic medications, which reduce bladder contractions
• Beta-3 agonists, such as mirabegron, which improve bladder storage

Your doctor will review possible side effects and determine if medication is appropriate.

Percutaneous Tibial Nerve Stimulation (PTNS)

PTNS is a minimally invasive treatment used for overactive bladder and urge incontinence.

During treatment, a small needle is placed near the ankle. Gentle electrical pulses travel through the tibial nerve to help control bladder function.

Treatment usually involves weekly sessions for about 12 weeks.

Sacral Neuromodulation

Sacral neuromodulation is a nerve therapy used when other treatments have not worked.

A small device, like the Axonics device or InterStim device, is placed under the skin in the upper buttock. The device sends mild signals to the sacral nerves that help control bladder function.

Treatment begins with a test phase to see if symptoms improve before placing the permanent device.

Botox Injections

Botox can be injected into the bladder muscle during a short outpatient procedure.
The medication relaxes the bladder muscle and reduces involuntary contractions.
Results often appear within one to two weeks and can last several months.

Pessary (For Women)

A pessary is a removable device placed in the vagina to support the urethra. It can help reduce stress incontinence without surgery.

Pessaries are especially helpful for women who also have pelvic organ prolapse.

Topical Estrogen Therapy

After menopause, lower estrogen levels can weaken vaginal and urethral tissues.

Topical vaginal estrogen helps improve tissue health and may reduce mild bladder symptoms.

Surgical Treatment Options

Surgery may be recommended when other treatments do not provide enough improvement.

For women with stress incontinence, common procedures include:

• Midurethral sling surgery, which supports the urethra
• Urethral bulking injections, which help the urethra close more effectively

For men, incontinence often occurs after prostate surgery. Surgical options may include:

• Male sling procedures, which improve control for mild to moderate leakage
• Artificial urinary sphincter, an implanted device that controls urine flow

Urinary incontinence is common, but it can be treated. A urologist can find the cause of bladder leakage and recommend the right incontinence treatment options in San Antonio.

If bladder leakage is affecting your daily life, schedule an appointment with our San Antonio urology team. We can review your symptoms and help you regain better bladder control.

1. Is urinary incontinence a normal part of aging?

No. While bladder leakage becomes more common with age, it is not a normal part of aging. Many effective treatments are available.

2. Can urinary incontinence go away on its own?

Sometimes mild symptoms improve with lifestyle changes or pelvic floor exercises. However, persistent leakage should be evaluated by a urologist.

3. How do doctors diagnose urinary incontinence?

Diagnosis usually begins with a medical history and physical exam. Your doctor may also use urine tests, bladder scans, or specialized bladder studies.

4. Should I see a urologist for bladder leakage?

Yes. Urologists specialize in bladder conditions. They can determine the cause of incontinence and recommend the most effective treatment options.