Not Making It
to the Bathroom in Time.
Urge incontinence is the sudden, overwhelming need to urinate — followed by leakage before you can reach the bathroom. It's not a hygiene issue. It's a nerve issue. And at Bladder Centers of America, we treat it at the source with sacral neuromodulation — the highest-ranked therapy in head-to-head clinical evidence.
Urge Incontinence at a Glance
What the research says about this condition and SNM
What is urge incontinence —
and how is it different from stress incontinence?
Urge incontinence is the involuntary loss of urine that occurs with a sudden, strong urge to urinate. The bladder muscle contracts involuntarily — before it's full, without warning — and the result is leakage before you can reach a bathroom.
This is distinct from stress incontinence, which is leakage triggered by physical pressure: coughing, sneezing, laughing, or lifting. Stress incontinence involves a mechanical failure of the sphincter. Urge incontinence involves a nerve signaling problem — the bladder is receiving incorrect instructions from the sacral nerve to contract at the wrong time.
That distinction matters because the treatments are completely different. Pelvic floor exercises help stress incontinence. For urge incontinence, you need to address the nerve — and sacral neuromodulation is designed specifically for that.
At Bladder Centers of America, urge incontinence is the primary condition we treat. Dr. McJunkin has performed more Axonics sacral neuromodulation procedures for this condition than any other physician on the planet.
Leakage from physical pressure
- Triggered by coughing, sneezing, exercise
- Often related to pelvic floor weakness
- Responds to pelvic floor therapy
- Not typically treated with SNM
Leakage from a nerve signal problem
- Triggered by a sudden, hard-to-defer urge
- Bladder contracts before it's full
- Often fails to respond to medication
- SNM is the highest-ranked therapy
Urge incontinence has a distinct pattern —
do any of these sound familiar?
These are the most common signs that what you're experiencing is urge incontinence, not just a "weak bladder."
The urge arrives fast and without warning
There's little or no buildup. You go from fine to desperate in seconds — often with no relation to how recently you last went.
Leakage before you reach the bathroom
The defining feature. The urgency is so intense that urine is lost before you can get there — even when you rush.
Going more than 8 times a day
Frequent daytime urination — often preemptively, "just in case" — is a classic compensating behavior that accompanies urge incontinence.
Waking at night to urinate (nocturia)
The same misfiring nerve signal that causes daytime leakage doesn't stop at bedtime. Nighttime urgency and waking 2+ times a night is common.
Mapping bathrooms everywhere you go
Every outing requires advance planning — where the bathroom is, how long until you can get to one. Spontaneous travel feels impossible.
Medications haven't provided lasting relief
OAB drugs (anticholinergics, mirabegron) help roughly 1 in 8 patients long-term. If they haven't worked for you, nerve-targeted therapy is the right next step.
The real cost of
living with urge incontinence.
Years of silent suffering
The average patient lives with urge incontinence for 6+ years before seeking specialty care. Most assume nothing can be done beyond pads and pills.
Hundreds of dollars per year on pads
Pads manage the leak. They don't address the nerve. Most patients spend $600–$900 per year on incontinence products — indefinitely, unless the underlying problem is treated.
Avoiding life
Flights, concerts, dinner out, intimacy — urge incontinence quietly shrinks the world patients feel safe inhabiting. The avoidance often outlasts any individual incident.
Side effects from long-term anticholinergic use
OAB medications carry real risks: dry mouth, cognitive decline, constipation, and — with long-term anticholinergic use — increased dementia risk in older adults.
Sacral neuromodulation — the therapy designed specifically for urge incontinence.
SNM doesn't suppress the bladder chemically. It recalibrates the S3 sacral nerve, restoring the normal communication between your brain and your bladder so contractions happen when they should — not at random.
From first call to dry days —
here's exactly what to expect.
Three steps. No surprises. You are in control at every stage.
External Trial
A temporary lead is placed near the S3 sacral nerve. You wear a small external stimulator for a few days and track whether leakage and urgency improve. Most patients notice a difference quickly. If not, the lead is removed and you've lost nothing.
Permanent Implant
A same-day outpatient procedure under local anesthesia with sedation. Many patients resume light activity the same day. Our team handles all insurance prior authorization at no cost. Dr. McJunkin performs every implant personally.
Freedom
Settings are fine-tuned over 2–8 weeks. The Axonics device lasts 10–20 years. It's fully reversible — turn it off or remove it at any time. Most patients report dramatic reduction in leakage episodes within weeks.
Trial first. Always.
Every patient at Bladder Centers of America completes the external trial before any permanent device is placed. You are never pressured — and you're always in control of whether to proceed.
How SNM compares to other
urge incontinence treatments
Not every treatment is right for every patient. Here's what the head-to-head research actually shows.
| Treatment | How It Works | Evidence for Urge Incontinence |
|---|---|---|
| Anticholinergics / Beta-3 agonists | Chemically suppresses bladder contractions | Only ~1 in 8 patients achieves durable control. Anticholinergics linked to dementia risk in older adults. Require ongoing daily use. |
| Pelvic Floor Therapy | Strengthens sphincter muscles | Effective for stress incontinence; limited benefit for nerve-driven urge incontinence. |
| Bladder Botox | Paralyzes bladder muscle | Effective short-term but requires repeat injections every 6–9 months. 1.55× higher adverse-event rate vs. SNM. UTI risk. |
| PTNS (Percutaneous Tibial) | Indirect tibial nerve stimulation | Requires weekly office visits for 12 weeks, then monthly indefinitely. Only ~26% maintain benefit at 3 years. |
| Sacral Neuromodulation ✦ | Directly recalibrates sacral nerve signaling | Ranked #1 of all therapies in 17-RCT meta-analysis. 93% of patients achieved ≥50% reduction. 15–20 year device life. Trial first. |
Sources: Wang et al., Toxins 2020 (17-RCT network meta-analysis) · Eftekhar et al., Int Urogynecol J 2020 · ARTISAN-SNM study, Pezzella et al. 2021 (PMID 33508155)
Dr. Tory L. McJunkin, MD — the #1 Axonics provider in the world.
More Axonics sacral neuromodulation procedures for urge incontinence than any other physician on the planet. Former Mayo Clinic faculty. Author of the definitive textbook on SNM. He personally performs every trial and every implant.
Your urge incontinence questions,
answered honestly.
What patients say after
getting their freedom back.
"What an amazing difference this place has made in my life. It is amazing to be able to go anywhere and no longer have to worry about having accidents."
"Best decision I ever made!!! Don't wait any longer. Staff is great & Dr is excellent!"
"I loved the staff and Dr. McJunkin. The process was easy and the results have been life-changing. I know it's a new technology, but I wish I could have done this years ago."
Medicare and most major plans
cover sacral neuromodulation.
No referral required. Our team handles your prior authorization at no cost to you.
Blue Shield
Coverage applies when medical necessity criteria are met — typically prior failure of conservative therapy. Call us to verify your benefits →
Urge incontinence often appears
alongside other bladder conditions.
You don't have to plan
your life around bathrooms.
Start with a free consultation — telehealth available. No referral needed. Dr. McJunkin personally reviews every case.