Technology has come a long ways in the last couple decades. Most of the women I talk to in my practice are unaware that there are such amazing non-surgical options for stress urinary incontinence. What once required surgery, pain, hospitalization, and a recovery time can now often be solved non-surgically, without pain, and no downtime.
If you’re someone who leaks urine when you sneeze, cough, laugh, workout, or any other scenario where you shouldn’t be leaking urine, then you likely suffer at least from stress urinary incontinence. Stress urinary incontinence can be mixed with other kinds of incontinence, like urge incontinence.
Now let’s talk about non-surgical treatment options for bladder leakage, what they are, and pros and cons of each.
Coping With Routine Care:
This is the most commonly used option. This means using absorbent pads for protection and laundry. Absorbent pads can cost up to about $900 per year or more. The biggest problem with using absorbent pads and other routine care measures is that they are just masking the symptoms. These measures are not addressing the underlying problem. It is unlikely that over time the problem would get better by simply doing this.
Pelvic Floor Physical Therapy:
This a commonly used therapy for stress urinary incontinence. Pelvic floor physical therapy generally involves doing things like supervised pelvic floor physical therapy. Supervised pelvic floor physical therapy generally requires a long 2-3/hour session weekly. Home pelvic floor physical therapy can involve doing things such as kegel exercises and can also include some kind of home biofeedback such as weighted vaginal cones.
Done properly, these can be helpful. The problem with pelvic floor physical therapy is that it can be time consuming, there can be compliance issues, and doing the exercises improperly so the right muscles are not strengthened.
A pessary is a silicone device that is inserted into the vagina. They work by physically pushing the urethra. This closes it to help prevent urinary leakage. The pessary devices aren’t correcting the underlying problem.
The biggest problems with the pessary devices though is that they irritate the vaginal tissue, cause a foul smelling discharge, and increase the risk of urinary tract infections. One would have to decide if this trade off is worth it before starting this kind of treatment.
An invasive procedure that can be done in-office or outpatient is called “bulking therapy.” Bulking therapy involves injecting a gel like bulking substance around the urethra just outside of the bladder. The idea being to make it more difficult for urine to leak fro the bladder into the urethra.
The limitations for an invasive procedure like bulking therapy are durability, efficacy, urine retention, and immune reactions. It is unclear how long it will last and how well it will work to undergo the procedure. If there is too much bulking substance, it could make it difficult to urinate and the bladder retains urine. Finally, there can be immune reactions that add complications.
There are different devices that are aimed at restoring the vaginal wall tissue. When the collagen in the vaginal wall weakens, it can destabilize the structures that help maintain the integrity of the urethra. This can lead to stress urinary incontinence.
Radiofrequency procedures heat the vaginal wall tissue triggering the body to heal itself by regenerating collagen restoring the vagina to a more youthful state. Some of the problems with radiofrequency devices is that they may require multiple sessions, they heat the tissue they’re in contact with so they have to be moved regularly (in and out motions can create a uncomfortable environment), and they can be more expensive.
There is one device, however, that doesn’t have those limitations. It is called a Viveve device. We carry that at Osteopathic Integrative Medicine. The Viveve is a one-session, non-surgical, painless procedure that has no downtime.
It has a unique technology that cools the surface it touches so it does not have to be constantly moving and can heat deeper making it more efficacious, and because it takes one session, it can be more affordable than many of the other radiofrequency or laser devices.
At the time of writing this, no radiofrequency devices exist that are FDA approved for stress urinary incontinence. Viveve is working towards FDA approval for stress urinary incontinence and vaginal laxity through the investigational device exemption (IDE) process.
This is the best option we have found at Osteopathic Integrative Medicine and that’s why we’re offering it.
If you suffer from stress urinary incontinence or sexual dysfunction such as vaginal dryness and loss of arousal, join us for a free webinar to learn more and find out how to get $500 off your treatment.
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