Leaking urine when you sneeze, cough or do anything physically exerting can be very embarrassing and inconvenient. Yes, it is a serious issue, but do you need surgery to rectify it? No. Don’t worry. Stress Urinary Incontinence can be managed without surgeries, too.
First, let’s understand what SUI stands for.
SUI – Stress Urinary Incontinence is a condition that affects both men and women, but more women than men. It is quite a common problem among post-delivery and in old age. Women suffering from SUI tend to leak urine involuntarily when there is pressure on the bladder. Sneezing, coughing, laughing too hard or even jumping and exercising can exert temporary pressure on the bladder, leading to a urine leak.
The exact causes for SUI are not very clear. Some of the commonly known risk factors are:
● Pregnancy
● Vaginal delivery
● Menopause
● Age
● Obesity or overweight
● Cognitive impairment
No one wants to leak urine when they are having a good laugh or just cough. This does not mean you need to go under the knife. Here are some non-operative options to manage SUI:
This is one of the first steps in treating urinary incontinence. This therapy involves changing fluid and food intake, timed visits to the toilet, maintaining a diary log, bladder control training, and exercises. In cases of mild urinary incontinence, this can help control the issue before it becomes serious.
Pelvic Floor Muscle Training (PFMT) is one of the first options any doctor or therapist would suggest for SUI. These exercises target the pelvic floor muscles and aim to make them stronger for better control. PFMT is highly recommended in addition to any therapy or treatment you choose for your SUI.
A vaginal cone is a small device similar to a tampon. You need to insert the cone into the vagina and keep it in place by actively contracting your pelvic floor muscles. Contracting the pelvic floor muscles in order to hold the cone in place helps strengthen the muscles responsible for keeping your urine. Your doctor will ask you to progress from light cones to heavier cones for optimal results.
In this treatment, the doctor uses mild electric shocks to stimulate the nerve endings near the urethra. It aims to stimulate reinnervation of the pelvic floor or cause a change in the muscle fibres that will help it react better. Not all doctors will suggest this treatment, as it has mixed results.
Some of the newer non-operative options for treating stress urinary incontinence are:
Platelet-rich plasma therapy involves drawing the patient’s blood and separating the platelets from the blood by centrifuging. The resulting plasma is injected back into the body around the urethra in five sites. This plasma will help repair and improve the tissues around the urethra, thus offering better support to reduce incontinence.
Injecting the PRP into the urethral sphincter can add bulk to the sphincter muscles and increase the urethral resistance. Studies show patients with both neurogenic and non-neurogenic SUI benefited from this injection and showed considerable improvement.
Behavioural therapy, PFMT and vaginal cones can all help in controlling SUI over a period of time. The treatments will slowly work on your bladder’s ability to control leakage. However, not everyone can wait that long, and the results are not guaranteed either.
PRP is a good option to treat SUI for the following reasons:
● It is minimally invasive
● Recovery time is much less
● Does not require months of therapy to start seeing results
● Can be used for young and old women
● Uses the patient’s blood, and hence no reaction or side effects to worry about
● Encourages localised clotting and reinforces the urethra
● Improves the blood flow to the genital area, which in turn reduces the incontinence symptoms and promotes better vaginal tissue health
● Increases the resistance of the urethra sphincter
● Improves vaginal elasticity, lubrication, and skin, leading to better orgasms and sexual satisfaction.
The EMSELLA chair is a revolutionary non-invasive physiotherapy treatment. It uses HIFEM (High-Intensity Electromagnetic energy) to strengthen and stimulate the entire pelvic floor muscle region. The session is 28 minutes long, and the patient sits on an EMSELLA chair, generating multiple supramaximal contractions in the pelvic floor muscles.
This therapy does not involve injections, medications, anaesthetics, or even undressing. There is also no recovery time, which means once the session is over, you can leave home immediately. Your doctor might recommend six sessions spread over three weeks for optimum results. However, you will start noticing results after the second or third session.
This new technology offers the following benefits:
● Repairs and strengthens pelvic floor muscles without any effort
● Noticeable improvement after the 1st session
● No hospitalisation and non-invasive
● Pain-free
● Fully clothed during treatment
● Targets the entire pelvic floor muscles region and not just the muscles that can be voluntarily exercised or controlled
● Every session is equal to 11000 pelvic floor exercises, which is not possible.
Laser therapy can make the vaginal tissues thicker and tighter by synthesising new collagen fibres. This extra tissue will offer support to the urethra and improve the continence symptoms. You can opt for the ablative CO2 laser or the non-ablative YAG laser.
Here are some advantages of choosing laser therapy for SUI:
● It is quick, pain-free and an out-of-office procedure that does not need hospitalisation
● No scars, sutures or anaesthesia
● Recovery is quick
● Can delay or even avoid surgery for incontinence in some cases
The treatments for SUI aim to improve the woman’s ability to control her urine. The treatments can help prevent the involuntary urine leak every time the pressure on the intraabdominal muscles increases.
Different treatments work differently for different people. So, there is no single solution for all. What works for you may not work in a similar fashion for others.
Laser, PRP, and EMSELLA are new treatments being used for various conditions, including SUI. These non-operative management options provide quick and lasting relief from an embarrassing problem.
● This is a revolutionary treatment that uses the patient’s own blood to treat their incontinence. Plasma from the patient’s blood is injected around the urethra to help improve incontinence symptoms.
● The most common types of lasers used to treat stress urinary incontinence are CO2 laser and YAG laser. Both are non-invasive and improve symptoms after the first session.
● Yes, since PRP uses the patient’s blood, there is no risk of reactions or rejections.
