Restoring Confidence: Our Approach to Urinary Incontinence

At Hera Health Care, we understand the significant impact that urinary incontinence can have on your daily life, overall well-being, and confidence. Led by Dr. Mirela Cernaianu, our mission is to provide personalized solutions for your wellness so you can regain peace of mind. With a comprehensive array of cutting-edge technology and a holistic approach to wellness, we are committed to empowering our patients to live life to the fullest once again. Learn more about our treatments for urinary incontinence below.

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Types of Urinary Incontinence and How to Differentiate Them

  • Stress incontinence:

    If you experience leakage when coughing, sneezing, laughing, lifting something heavy, jumping, running, or during physical activity in general, you likely have stress urinary incontinence. This condition accounts for approximately 50% of all cases of urinary leakage in women.
  • Urgency incontinence (overactive bladder):

    If urine leaks when you have a strong urge to urinate, such as on the way to the bathroom or immediately after feeling the urge to void, you may have urge urinary incontinence. This condition is also known as overactive bladder. It affects about 20-25% of women with urinary leakage.
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Is it an Overactive Bladder?

Do you need to know where the next bathroom stop is, and always need to plan ahead when traveling? Do you wake up more than 2-3 times every night to urinate? Do you need to run to the bathroom as soon as you get the urge to go and can only hold it for a few minutes? Then you likely suffer from overactive bladder (possibly Interstitial Cystitis).

Causes of Urinary Incontinence

While overactive bladder/bladder spasms are mainly due to pelvic floor tissue and muscles weakening, there are many causes that contribute to it:

  • Your brain may not send the proper signals telling you it’s time to urinate, or nerves that control bladder muscles may not work.
  • Muscles that hold in urine or that support the bladder may weaken. Bladder muscles may contract too much or not enough, due to problems in the muscles or nerves.
  • Menopause: Less estrogen causes deterioration of bladder lining.
  • Hysterectomy: Removing the uterus may affect pelvic floor muscles.
  • Age-related changes: Bladder muscles weaken and involuntary bladder contractions increase.
  • Childbirth: Vaginal delivery might have affected muscles and nerves used for bladder control.

Stress incontinence can be caused by:

  • Weakening of the tissues and muscles that support the urethra and the bladder, most commonly related to childbirth trauma.
  • Pelvic organ prolapse: Pelvic floor muscles that support the bladder weaken, and organs may drop towards the vaginal entrance – most commonly caused by pregnancy and childbirth trauma, post-surgery involving the pelvic organs, or postmenopause as estrogen loss affects the health of tissues in the pelvic and vaginal area.
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Therapies for Urgency Incontinence

Therapies for urgency incontinence include:

  • Lifestyle modifications and fluid intake changes.
  • Exercises to strengthen pelvic floor muscles – KEGEL at home.
  • Pelvic floor therapy with a therapist – a consult and prescription is required but it is covered by most insurance plans.
  • Bladder training.
  • Biofeedback TENS at-home use device – ATTAIN*.
  • Medications.
  • Estrogen therapy – systemic HRT or local vaginal Estrogen.

Non-Surgical Treatments for Urinary Leakage and Incontinence

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IncontiLase® Fotona Treatment for Urinary Incontinence

IncontiLase® is an innovative, patented, Er:YAG laser therapy for mild and moderate stress urinary incontinence (SUI) based on the revolutionary, non-invasive Fotona SMOOTH® technology.

The procedure uses a glass speculum that stays intravaginally for the entire duration of the treatment, allowing for total comfort during the procedure.

FOTONA provides a solution for:

  • Mild and moderate stress incontinence.
  • Photothermal tightening of the urethral and anterior bladder wall region.

Key features of IncontiLase® Fotona treatment:

  • Incisionless and minimally invasive.
  • No anesthesia is needed.
  • It is a walk-in/walk-out procedure.
  • Safe, quick, and easy.
  • High success rate and patient satisfaction.

Treatment Details:

  • A series of 3-5 treatments is required, depending on the severity of the symptoms and whether urinary leakage is associated with prolapse of the bladder wall or not.
  • Treatments are done monthly, at a time when the woman is not experiencing vaginal bleeding.

The IncontiLase® Fotona treatment utilizes the "smooth mode" which allows it to penetrate deeper than most other lasers. It delivers laser energy onto the vaginal tissue in a fast sequence of low fluence laser pulses inside an overall super long pulse of 200-300 milliseconds. This causes gentle heating of the tissue without any ablation.

How does IncontiLase® work?

The laser used for IncontiLase® features a built-in technology called Fotona SMOOTH® that enables delivery of precisely controlled laser-induced thermal effects. These effects stimulate collagen neogenesis and remodeling in the mucosa tissue, specifically in the region of the vestibule and urethral orifice, as well as along the anterior vaginal wall.

The end result of the IncontiLase® treatment is non-ablative photothermal tension, shrinkage, and tightening of the tissue in the urethral and anterior bladder wall region, leading to the restoration of normal continence function.

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Viveve Vaginal Tightening Treatment

Viveve is a safe laser treatment that uses cryotherapy to cool the tissues and then follows with RF (radiofrequency) to allow heat to penetrate and affect collagen tissue in the treated area. Volumetric radio frequency is delivered (90J/cm²) 3-5mm into vaginal tissue, improving blood circulation and stimulating collagen formation.

Viveve is a painless, noninvasive vaginal tightening procedure that can rejuvenate the vaginal area and boost sexual health.

The collagen stimulation starts immediately after the procedure, with the body continuing to produce new collagen and remodel existing collagen. This process tightens and lifts tissues, providing improved support for the lower bladder and urethra, leading to enhanced urinary control and sexual satisfaction.

Additional Benefits Include:

  • In-office treatment.
  • No incisions, needles, or scars.
  • No sign of treatment at all.
  • No sedation or anesthesia needed.
  • No downtime or recovery.
  • No discomfort or pain.

Treatment Timeline and Results:

Major changes may not be noticeable until 6-10 weeks after the procedure, with the best results achieved three months after starting treatment. The maximum effect will be felt at 6 months post-procedure.

85-90% of patients experience at least a 50% improvement in their condition.

Viveve provides a safe and comfortable single-session treatment that lasts about 30-45 minutes. An annual maintenance treatment is required at 12-18 months to maintain the benefits of the procedure.

TempSure Vitalia Women's Wellness Treatment

TempSure Vitalia is an FDA-cleared radiofrequency (RF) system designed to enhance women's wellness. The small probe of the system is inserted into the vaginal canal and moved around the external labial skin, delivering waves of monopolar RF energy to gently heat delicate tissue. This process increases blood circulation and stimulates tissue regeneration and the growth of new tissues.

Most women start noticing benefits within a few days of TempSure Vitalia treatments. Mild inflammation or swelling may occur initially, but these side effects fade away as new tissues form. Dramatic benefits can be experienced within 2-4 weeks.

While results can be achieved after a single session, 3-5 treatments are recommended for more complex skin laxity concerns. Maintenance treatments once or twice a year are also recommended to ensure long-lasting results.

TempSure Vitalia can treat various issues women face due to pregnancy, menopausal hormonal fluctuations, or inherited conditions. It can:

  • Decrease involuntary bladder leakage.
  • Tighten and firm loose vaginal skin.
  • Restore vaginal mucosa to resolve vaginal dryness.
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ATTAIN® Urinary Incontinence Treatment

ATTAIN is a medical device used to treat stress, urges, and mixed urinary incontinence in women. The device is inserted into the vagina and helps strengthen certain muscles while relaxing overactive bladder muscles.

ATTAIN therapy achieves results using the following techniques:

  • Inflation to provide resistance to muscles.
  • Voice-guided exercise program to indicate when to contract and relax muscles.
  • Visual biofeedback to show whether muscle contractions are held long enough.
  • Ensuring muscle relaxation to avoid constant contraction.
  • High-frequency electrical stimulation to trigger full muscle contraction.
  • Low-frequency electrical stimulation to relax bladder muscle spasms.

You can use ATTAIN at home, with each session lasting about 12 minutes. It is recommended to use ATTAIN six days per week for 10-14 weeks to resolve urinary incontinence, followed by once or twice a week for long-term maintenance.

ATTAIN may be covered by your health insurance plan. InControl Medical guarantees their product, as illustrated in the provided link.

MonaLisa Touch Vaginal and Urinary Health Restoration

The MonaLisa Touch is an advanced fractional CO2 laser that effectively helps with vaginal dryness and vaginal atrophy. The laser is gently inserted into the vagina, delivering laser energy to the vaginal wall tissues. The proximity of the bladder to the anterior vaginal wall ensures that the healing process promoted by the laser will also affect adjacent organs like the bladder and urethra.

The laser stimulates the production of new collagen and elastin in the vaginal wall and increases blood flow in vaginal tissues. This leads to improved vaginal tone, texture, and lubrication, restoring normal function and relieving symptoms of vaginal atrophy such as dryness and painful sex. Additionally, it significantly improves frequent UTIs, urinary frequency and urgency, and other urinary symptoms, greatly enhancing quality of life.

Usually, 85-95% of women treated with MonaLisa Touch notice relief from urinary leakage caused by urgency and resolution of leakage caused by mild stress urinary incontinence.

The laser treatment lasts about five minutes and doesn't require anesthesia, as it is well-tolerated by most women. Slight redness or swelling may occur after the procedure, but no downtime is needed for recovery.

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EmSella Pelvic Health Restoration

EmSella is a revolutionary non-invasive treatment designed to restore pelvic health and address urinary incontinence. This innovative technology utilizes electromagnetic energy to stimulate and strengthen the pelvic floor muscles, providing a non-surgical solution for improved bladder control and enhanced quality of life.

How Does EmSella Work?

During an EmSella treatment session, you will be comfortably seated on a specialized chair that emits high-intensity electromagnetic waves. These waves penetrate through your clothing and stimulate the pelvic floor muscles, inducing thousands of supramaximal contractions. These powerful contractions strengthen and rehabilitate the pelvic floor, promoting muscle tone and functionality. The treatment is painless, and most individuals report a sensation of muscle contractions during the session. Each EmSella session typically takes around 20 minutes to complete.

Benefits of EmSella

  • Improves bladder control and reduces urinary incontinence episodes.
  • Strengthens and tones the pelvic floor muscles.
  • Enhances pelvic floor support and stability.
  • Restores confidence and quality of life.
  • Non-invasive and non-surgical treatment option.
  • Painless and comfortable procedure.
  • No downtime or recovery period required.


EmSella is a non-invasive procedure that requires no downtime or recovery period. After the treatment, you can immediately resume your regular activities without any restrictions. It is common to experience a mild sense of muscle fatigue or soreness, similar to the feeling after a workout, which typically subsides within a day or two. Regular EmStella sessions are typically recommended to achieve optimal results.

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