Survey shows the negative mental impacts of suffering from bladder leakage may outweigh the physical impacts

We recently surveyed 100 women across the US to better understand their experience with stress urinary incontinence, also known as light bladder leakage or “mommy bladder”. We wanted to better understand how women were managing their leaks and how it impacted their daily lives. We originally conducted the survey for our own internal purposes, but after reviewing the results I thought they were worth sharing. While many of our findings were not shocking to me or my team, it illustrates that stress urinary incontinence is not just a physical condition, but also a condition that has a significant negative impact on women’s’ mental health.

Stress urinary incontinence is a quality-of-life issue – it impacts women on a daily basis either through physical leaks or the constant worry of the next unexpected sneeze. In our survey, 76% of women said they experienced leaks at least a few times per week, with 38% experiencing daily. However, women appear to think about their leaks more often than they occur – 50% of women said they think about their leaks daily, despite only 38% actually experiencing leaks on a daily basis.

how often women experience their leaks vs think about their leaks

Despite being top of mind for women – many women are unwilling to speak up or even seek help for the condition. Only half of the women suffering from stress urinary incontinence said they have spoken to their friends or family about their condition. A disappointing revelation given that stress urinary incontinence is common as it impacts 1 in 3 women (source).

who have you spoken to about leaks

Even more disappointing is that women appear to be unlikely to seek professional help. Roughly half of women have spoken to their doctor about their condition and less than a quarter have spoken to a pelvic floor physiotherapist, who can be a game changer for the condition. This is consistent with our many discussions with physicians who have said that women often need to be prompted to discuss whether they suffer from stress urinary incontinence, rather than offering up that on their own.  This speaks to the “taboo” nature of SUI.  Despite being extremely common, women are embarrassed to open up about it, even though it’s as natural as a headache or a runny nose.

Women also admit to being quite bothered by their leaks – 64% women indicated that they were somewhat to highly bothered by their leaks. When asked what bothered them the most about their leaks, the common themes were: odor, feeling unclean, embarrassment or public anxiety, and the unpredictability of when a leak might occur.  The constant overhang of these issues can lead to anxiety, withdrawal from social activities and in more severe cases, depression.

level of acceptance of their bladder leaks

Given that few women seek help for the condition there is little surprise that most women are passively managing their leaks with disposable pads – over 66% of women noted that disposable pads were their most commonly used solution for managing their bladder leaks. Despite it being the most common solution, women are just not truly satisfied with disposable pads. Less than 50% of women are satisfied with pads as a solution and 68% expressed concern around the environmental impact of pads.  Women deserve better solutions for their health and we should not accept living with urine leaks as simply part of “being a woman”.

percentage of women commonly using

Enough is enough – it is 2021 and women need to know there is a better alternative to pads. Pads don’t stop bladder leaks or remove the anxiety around them, and they actually cost you way more than you realize on an annual basis. Pads are like putting out a bucket in your living room to capture a leak in your roof and just emptying the bucket each day and never trying to stop the problem.

Uresta checks all the boxes that disposable pads don’t … Uresta is reusable and environmentally friendly, discreet and comfortable, and most importantly it stops leaks vs. absorbing them. Stopping leaks can free women of the anxiety of odor, feeling unclean or the unpredictability of when the next leak will occur. Uresta is a truly game changing solution that has the impact to improve the quality of life for thousands of women.  Don’t be afraid to open up about your urine leaks, odds are, 1 in 3 women around you at this moment will also experience them.  Just give Uresta a try – risk free.  And importantly, tell your friends and family about it.  They will thank you when they are finally able to live life without leaks.

From Pomegranates to Pessaries: How historical pee-leak solutions informed Uresta’s design.

Dr. Scott Farrell, the inventor of Uresta, tells all about the inspiration behind his revolutionary, modern device.

Dr. Scott Farrell Uresta

As the inventor of Uresta, I get a lot of questions. What’s your background? Why did you invent a pee-leak solution? Why did you name it Uresta? What in the world is a pessary? Urogynecology? Well, I’ve decided it’s time to answer some of these questions.

What’s your background?

I am a Urogynecologist (a physician who specializes in women’s pelvic health), and a professor at Dalhousie University Medical School in Halifax, Nova Scotia, Canada. I did my residency training in Canada, then went on to do a fellowship in Urogynecology and Female Pelvic surgery in Long Beach, California. Eventually, I returned to Canada to set up my clinical practice in a teaching hospital in Atlantic Canada. Over time, I have become recognized as an accomplished surgeon and an expert in my field. But my years of experience treating women with unwanted urinary leakage led me to understand that there was something missing in the treatment options available for women with stress urinary incontinence. That’s when my attention turned to pessaries.

What’s a pessary?

It’s a device that’s inserted into the vagina to help with pelvic organ prolapse and urinary leaks.

Why haven’t I heard of pessaries before?

In the world of Urogynecology there’s a strong focus on using surgery to correct urinary leaks. And in my four years of medical school training, pessaries were never mentioned. They were considered by most of my teachers and colleagues to be antiquated devices from a bygone era. We were trained to be surgeons and to treat problems the modern way: with surgery. And while surgery is a great option for some, not everyone wants to undergo it, or can afford it.

What were historical pessaries like?

Early pessaries were fashioned from natural materials, such as wax balls, fruits like pomegranates, and cloth. Some were even carved from wood or fabricated using other natural materials. They’ve been in use for thousands of years. But, of course, complications arose when these materials were placed inside the body.

It was a long time before modern pessaries entered the scene. And when vulcanization was developed, rubber pessaries could be mass-produced by companies and provided to medical professionals.

These days, pessaries are made of inert thermoplastic elastomers or silicone.

Examples of early pessaries

Examples of early pessaries.

Is Uresta the only pessary that people still use today?

No, there are others called ring pessaries but, as I discovered, they have their drawbacks. Firstly, they must be fitted by a doctor. And while a small percentage of our patients could take care of their ring pessaries themselves, the majority had to come back for regular visits to have their pessary removed, cleaned, and re-inserted.

That’s why I wanted to create an easy, at-home solution for women that actually works.

How did you turn your inspiration into the actual Uresta product?

I set about developing a rudimentary design for my user-friendly pessary. Inspiration based on my clinical medical knowledge, and plasticine models I created, resulted in the first Uresta prototype! I then received Health Canada regulatory approval to conduct an investigational clinical trial of my invention to test its effectiveness and safety. The clinical study showed that the Uresta worked safely to successfully treat stress incontinence and that women welcomed it.1 Clinical experience with Uresta and other research about Uresta have confirmed this success.2,3

How is Uresta different from other pessaries?

Uresta lets women take control of their own pee-leak solution. They don’t have to go to the doctor to get it fitted, and they can insert it/remove it at home as the tapered end of Uresta allows for easy insertion into the vagina. And the bell shape means that the widest portion sits under the urethra, providing necessary support. The design also prevents Uresta from rotating out of place. The handle allows women to control Uresta as it’s inserted, and to grasp it for easy removal. And last, but not least, it’s comfortable!

Why did you call it Uresta?

The word “Uresta” can be broken up into 3 parts: “ur” represents the problem of urine leaks, “rest” represents the rest from pesky urine leaks, and “ahh” represents the sigh of relief women express when they are no longer worried about leaks.

1.Farrell SA, Baydock S, Amir B, Fanning C. Effectiveness of a new self-positioning pessary for the management of urinary incontinence in women. Am J Obstet Gynecol. 2007 May;196(5):474.e1-8. doi: 10.1016/j.ajog.2006.11.038.PMID: 17466709

2. Lovatsis D, Best C, Diamond P. Short-term uresta® efficacy (SURE) study: a randomized controlled trial of the Uresta continence device. Int Urogynecol J. 2017; 28(1):147-150.

3. Gallagher L, Woodcock D, Massey L. Product Reviews. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy. 2019; 124: 63-66.

Weight loss tips to help manage stress urinary incontinence

Your doctor may have told you that you have urinary incontinence, and this could be stress urinary incontinence or an overactive bladder. One in 3.3 million Canadians, nearly 10% of the population, experience urinary incontinence, so you are not alone (1). Weight loss, through nutrition and exercise changes, is one of many strategies to reduce the frequency of stress urinary incontinence (2,3), but weight loss is easier said than done for many. Reducing the likelihood of yo-yo dieting and regaining weight is important when considering weight loss. If you are planning to make nutrition changes to support weight loss and a new lifestyle, here is a registered dietitians’ shortlist of some important things to consider, starting with letting go of past habits.

  1. Nutrition misinformation – look for red flags

Many fad diets promote eliminating food groups – poor carbohydrates, they always get picked on – and eating too few calories to fuel our daily needs and activities. The media tells us that we need to eat a certain number of calories per day to support weight loss (*ahem* 800-1000 calories which is similar to what a child would need, not a full-grown adult), but this could not be further from the truth. While a reduction in calories may be needed to support weight loss, it is not the be all and end all. What is important to support weight loss is the quality of calories. A registered dietitian can help you understand how to make changes to the foods you are consuming, and promote foods that will help support weight loss and keep you full, as well as estimate the number of calories you may need (which is likely a lot more than 800-1000 calories). Eating an insufficient quantity of calories can actually harm your metabolism.

A weight loss program that promotes eliminating a food group is not going to be sustainable: what is important is the quantity you eat. At each meal aim for:

  • ½ plate in vegetables and fruit
  • ¼ plate in starches choosing whole grain and low glycemic index carbohydrates that are full of fibre to keep you full
  • ¼ plate in lean proteins, including plant-based proteins more often
  • Small amounts of healthy fats

Start your weight loss journey by reflecting on how your meals compare to this list. Weight loss should not be an all-or-nothing approach to food groups.

  1. Weighing yourself daily and aiming for a magical number on the scale
    Your weight can fluctuate day-to-day because of many factors. 
    Hydration, what you eat, hormones, and even your bowel movement frequency can and will vary what you see on the scale. If you are going to weigh yourself, limit it to once per week or once per month and choose the same time of day each time, like first thing in the morning. Losing 1-2 lbs per week is considered healthy and gradual weight loss. That being said, there are many changes you can notice that are not weight related, like how your clothes are fitting, or your energy levels.
  2. Denying yourself the pleasures of your favourite foods
    Cauliflower does not need to be a substitute for mashed potatoes, rice, pizza crust or anything else that you think tastes good.
    You can still eat your favourite foods and lose weight. Remember food quality and quantity is important. Fad diets often cause us to become hyper-focused on foods until it controls our life and prevents us from enjoying our favourite meals. When thinking about sustainable and realistic weight loss, we want to develop healthy lifestyle habits. Try this: instead of having 4 slices of pizza with your family, maybe you reduce it to 2 slices and choose a pizza full of vegetables instead of deli meats, and add a side salad or chopped vegetables and dip to round out your meal. When you classify foods as bad or good and then eat a food you’ve called “bad”, you end up telling yourself that you are bad. At the end of the day, food is food, and no particular food is better or worse for you (within reason, don’t go drinking olive oil direct from the bottle): it is all about how we include it in moderation. 

Nutrition and weight loss play a role in managing stress urinary incontinence as it reduces the pressure placed on your bladder. You are going to be more successful with weight loss if you think about your lifestyle and find something that fits your regular routine. If you need help strategizing meals that are nutritious and delicious, and can help keep you full while supporting weight changes, working with a registered dietitian can be a great starting point and can provide ongoing support.

Emily Campbell is a registered dietitian and certified diabetes educator with a Master of Science in Foods and Nutrition. With years of nutrition experience, Emily is passionate about supporting individuals to make healthy eating delicious, nutritious, and easy to understand. Nutrition is complex, but Emily helps to break it down into easy-to-digest concepts to help individuals make sustainable nutrition changes that work with their preferences and lifestyle. Follow Emily here for more nutrition topics: 

Instagram: @kidneynutrition

Website: emilykidneynutrition.com

References:

  1. “FAQ’s,” The Canadian Continence Foundation, last modified 2021, accessed May 8, 2021 https://www.canadiancontinence.ca/EN/frequently-asked-questions.php 
  2. Emily L Whitcomb, Leslee L Subak, “Effect of weight loss on urinary incontinence in women,” Open Acess J Urol 3 (2011): 123-132, doi: 10.2147/OAJU.S21091 
  3. Rena R. Wing, et al., “Effect of Weight Loss on Urinary Incontinence in Overweight and Obese Women: Result of 12 and 18 Months,” Adult Urology 184, 3 (2010): 1005-1010, doi: 10.1016/j.juro.2010.05.031

Is my vagina broken?  What is pelvic organ prolapse and stress incontinence?

In our last blog, we talked about the anatomy and function of the pelvic floor or Kegel muscles.  We discovered that both male and female bodies have three LAYERS of muscle with multiple muscles in each layer. And that these muscles provide the following functions in our bodies:

  1. Supportive: of the pelvic organs (bladder, rectum, uterus, prostate)
  2. Sphincteric:  opening and closing of the urethra, vagina and anus
  3. Sexual:  contributing to arousal and orgasm
  4. Stabilizing:  with a host of other muscles pelvic floor contributes to stability of trunk, pelvis and hips
  5. Posture:  maintains good posture along with back and abdominal muscles
  6. Breathing:  the pelvic floor and your main breathing muscle, the diaphragm, coordinate together
  7. Pumps fluids: contraction and relaxation of pelvic floor muscles supports the flow of fluids in the body

Today we are going to learn about how pelvic floor function relates to pelvic organ prolapse (POP) and stress urinary incontinence (SUI). 

Pelvic Organ Prolapse is a condition where your internal pelvic organs (bladder, uterus, rectum) have shifted position and lean toward the vagina.  This usually happens because the ligaments and support tissue that hold the organs in place have been stretched.  People with prolapse often have a sense of a bulge in the vagina or difficulty emptying their bladder or bowel.  The pelvic floor muscles can also play a role. Strong muscles might help support the displaced organ, while weak muscles might lead to more symptoms. You can read more about pelvic organ prolapse here.

  Normal Female Pelvic Anatomy vs. Cystocele (bladder prolapse). A dropped or prolapsed bladder (cystocele) occurs when the bladder bulges into the vaginal space. It results when the muscles and tissues that support the bladder give way.

Stress Urinary Incontinence (SUI) happens when you accidentally leak urine when you cough, sneeze, laugh, lift, jump, run or otherwise experience an increase in intraabdominal pressure.  The urethra (tube from your bladder to the outside of you) doesn’t stay closed and some urine escapes.  This condition is often referred to as light bladder leakage and some women refer to SUI as their “mommy bladder,” reflecting the fact that childbirth often contributes or causes SUI to develop. 

  A diagram of a normal bladder & urethra (on the right) vs. a bladder & urethra that has stress urinary incontinence

A good analogy for SUI is a leaky faucet. It would be that the valve is just not closed all the way (weak muscles) or perhaps it is broken and unable to close (structural changes).  In the same way, there are various reasons why the urethra does not fully close and contributes to urine leakage. 

What causes bladder leakage related to stress urinary incontinence? There can be many factors that contribute to bladder leakage such as:

  1. Being overweight
  2. Straining with constipation
  3. Vaginal childbirth where you pushed for more than 2 hours or less than 30 minutes
  4. Vaginal childbirth with forceps
  5. Having multiple pregnancies and deliveries
  6. Having twins, triplets etc.
  7. Giving birth at an older age
  8. Damaged nerves
  9. Pelvic surgery
  10. Certain medications like diuretics or water pills

You can read more about stress incontinence here.

You might think that only nonfunctioning or weak muscles would present with the symptoms of stress incontinence or prolapse, but I can tell you from many years of experience that I have seen a range of muscle presentations with these symptoms. For example, often times women with leakage or prolapse develop a habit of habitually tightening their pelvic floor muscles which can lead to overactivity, pain and muscles that don’t function well.  

We will talk about the difference between and importance of pelvic floor strengthening or kegel exercises, relaxation, and coordination in a future blog! 

Wouldn’t it be helpful to know how YOUR pelvic floor muscles are functioning! 

A specialty trained pelvic health physical therapist can evaluate the state of your muscles and organs and provide a customized treatment program to meet the needs of your body.  Muscles can be trained through physical therapy to improve in function regardless of their current state.  

Now here’s some really good news. Uresta works regardless of pelvic floor muscle function and can provide immediate support to your organs, ligaments, and connective tissue.  Uresta works in theory like an ankle brace. Image you had a bad ankle sprain but really wanted to get back to running.  An ankle brace could support your body while you are working on your recovery.  The ankle brace might be something you use short term, or just as needed.  Or, maybe the injury to your ankle was more severe and using the brace may be an important part of your daily self-care.  

Use of Uresta to support the bladder and urethra works much the same way. Some people may use it just for exercise, while others will find the most benefit using it on a daily basis. Easily inserted vaginally, Uresta helps to keep the urethra closed and the bladder supported with increases in intraabdominal pressure, so that you can do the things in life you love without worrying about prolapse or leakage.  

There is no reason for women to suffer in silence with pelvic floor dysfunction, prolapse, or stress incontinence.  Help is available!  

Our former CEO, Carol Chapman, talks all about feelings of shame, the lack of funding in women’s health, and how Uresta’s changing the pee-leak game.

Women-led Uresta is changing the game for people suffering from pee leaks.

Stress Urinary Incontinence (SUI) is a very common condition suffered by 1 in 3 women globally and yet, as sufferers, even today, we largely suffer in silence. SUI, commonly referred to as Light Bladder Leakage (LBL), is a common result of childbirth and is triggered when women cough, laugh, sneeze or exercise.  Many women are affected by SUI for decades, and yet are still reluctant or embarrassed to speak out, most often continuing with traditional pads or opting for surgery (most often midurethral sling, sling surgery, and mesh surgery).

 

One of my closest friends for over 30 years suffered from SUI, as did I, and we never once spoke of it despite discussing almost everything else in our lives.  She even had multiple surgeries to try and address her stress urinary incontinence and after 8 years she was still experiencing leaks. Today, both of us are successful users of Uresta bladder support and wish that we would have simply opened up about this issue years prior and been empowered to find better solutions for ourselves.  Like so many other women, she could have avoided surgery altogether.

 

I first heard of Uresta bladder support and met its inventor, urogynecologist Dr. Scott Farrell, when a former colleague introduced us for a potential marketing consulting engagement.  I immediately realized what an extraordinary product I had just been introduced to and quickly rallied a group of women entrepreneurs that I knew would be interested in investing in the business. Whether they had SUI or not, they all knew women who did, and recognized the terrible stigma and embarrassment associated with stress urinary incontinence.  It was clear to us from day one that Uresta introduced a new sense of empowerment to female SUI sufferers that was safe, comfortable, effective, non-invasive, and affordable. Gone were the days of uncontrolled leaks, urine, odour, wet pads and avoidance of outings with friends and family. While traditional pessary devices for treating SUI have been around for decades, Uresta was one of kind in that it is a self-managed pessary. Women can easily remove or insert Uresta, unlike other pessary devices which need to be removed, inserted and cleaned by a physician multiple times a year. Uresta offers the self-managed aspect of pads but the elimination of leaks and odour offered by a pessary – offering the ultimate bladder support for women.

 

Today, Uresta continues to be a game changer in female incontinence and our Company’s efforts are focused on building awareness regarding SUI and letting women know a better solution than surgery, traditional pessaries and pads exists.  Whether women are in their 30s or 60s, they truly need to know an amazing option exists that will allow them the quality of life and empowerment they deserve. Our goal is simple, to educate and inspire a growing community of women everywhere to stop allowing bladder leaks to hold them back from anything!

Promoting Uresta at a healthcare conference in 2018

 

As women entrepreneurs, we understood our approach to market needed to be credible, relevant, thoughtful, and informative, while also being bold, direct, and disruptive.  It has taken decades for women to even admit they suffer from SUI and that they deserve credible options to live their best “life without leaks”. Our conversations are multi-faceted with the goal of reaching all possible influencers, to ensure the compelling story of Uresta reaches healthcare professionals, insurers, advocate groups and most importantly women, that on average will be affected by SUI at some point in their lives.

 

Our shareholder group continues to be comprised of a number of successful and influential women; the chair of a top Canadian bank, CEO of a renewable energy company, lead partner for a global consulting firm, division head of a global pharmaceutical company, and many other successful professionals and entrepreneurs.  These champions of Uresta recognize the need for change and that women’s health globally, has been underfunded for decades.

Uresta  wins 2016 Product of the Year Canada award in the adult care incontinence category.

In early 2021, I retired as Uresta’s CEO and remain an active board member, shareholder and proud advocate for Uresta and women’s health.  As part of this transition, we were excited to bring on our new CEO, Lauren Barker, a bright accomplished young female leader who will help grow consumer awareness and introduce Uresta to more women than ever before.

 

Today’s generation of women boldly advocate for their own health and are far less embarrassed to admit they suffer from conditions such as SUI. Massive change is happening, lets be bold together.

What IS the pelvic floor and what does it DO in my body?

An Introduction to Pelvic Floor Anatomy and Function in Women & Men

The Pelvic Floor is finally starting to get the press it fully deserves in our culture.  As a Physical Therapist who specializes in pelvic health, I often see magazine articles, websites and new products being developed to help educate, empower and support pelvic floor function.

But I am willing to bet that most of us are not very familiar with the unique architecture and function of this remarkable part of our body.  Read on for an anatomy lesson on the pelvic floor and learn about all the important bodily functions it plays a key role in.

The pelvic floor complex is comprised of 10 muscles in female bodies and 8 muscles in male bodies that are formed into three layers.  The following is a tour through each of those layers’ structure and function.

Functions of Your pelvic floor muscles

  1. Supportive
  2. Sphincteric
  3. Sexual
  4. Stabilizing
  5. Posture
  6. Breathing
  7. Pumps Fluids

 

Layer 1: Muscles that support sexual and support functions

In female bodies, layer one pelvic floor muscles support the vaginal and anal openings by forming the band of tissue between the vagina and the anus (perineum).  These muscles help with blood flow to the clitoris during arousal and hug the vaginal opening.

 

Muscle of the female perineumThese muscles are often injured or torn during vaginal childbirth. 

In male bodies, layer one is also helpful for sexual functioning by maintaining erection, plays a role in urination, and provides muscular support to the area between the testicles and the anus (perineum).  Weakness in these muscles can contribute to urinary leakage and erectile dysfunction.

In both male and female bodies, the external anal sphincter is also part of layer one muscles.  The anal sphincter plays a big role in coordinating defecation.

 

 

Muscle of the male perineum

 

Layer 2: Muscles that coordinate and control urination

Female bodies are more prone to issues with urinary incontinence for several reasons:  they lack a prostate gland, have a shorter urethra, may experience the stress and strain of pregnancy and childbirth, and lose estrogen which may negatively affect continence.  Luckily, the second layer of pelvic floor muscles offers some compensation for this.  Male bodies have just two muscles here, while female bodies have four that offer additional support around closing the urethra.

These muscles may be weak, poorly coordinated, or overactive which usually presents as urinary dysfunction:  leakage, urgency, spraying, dribbling.

 

Layer 3: Muscles that support our pelvic organs

The third layer is relatively the same in both female male bodies and is busy with many functions.  These muscles provide support for the pelvic organs (bladder, urethra, rectum and prostate in male bodies; bladder, urethra, vagina, uterus, and rectum in female bodies).    They are important for sexual functioning and orgasm.  The third layer of pelvic floor muscles also join in with a network of other muscles of the body to provide postural stability, coordinate with the diaphragm (the main breathing muscle) to assist in breathing, and even form a kind of pump to help move blood and fluids from the lower body back to the heart.

 

This layer is susceptible to stretch injury from pregnancy and childbirth, weakness from chronic straining (lifting, coughing, constipation), problems from nerve damage or surgery, and structural weakness that happens with loss of estrogen.

Overactivity in this layer can occur with chronic pain, trauma, musculoskeletal problems like low back or hip pain, surgery, clenching/stress and tension, and tailbone injuries.

Levator ani structure

Your hip bone’s connected to your …

Pelvic floor view looking from above

There is one more muscle I’d like to highlight, that isn’t exactly a pelvic floor muscle but sometimes gets called part of the pelvic WALL.  This muscle is interesting and unique in that it is actually a HIP muscle and it’s job is to externally rotate and stabilize the hip joint.  BUT it literally attaches right into the pelvic floor.  Sooo your hip bone IS attached to your pelvis just like the old song says!

This image shows the view of the pelvic floor looking from above.  You can see the Obturator Internus muscle outlined in blue (with arrows) and the third layer of the pelvic floor outlined in red.

Research has found that this muscle is also an important factor in pelvic floor function and via it’s anatomy, it links hip and pelvic function.

Studies in both female and male bodies show that exercising this muscle can be just as effective as exercising your pelvic floor in relieving stress urinary incontinence or accidental urine leakage.

I bet you just got a pretty good education on a part of your body you didn’t know much about!  In our next blog we’ll talk about how problems in pelvic floor muscle function occur and the symptoms this can cause.

If you like learning, stay tuned for future blog posts covering topics like …

  • What happens when there is pelvic floor dysfunction?
  • Why pelvic health is more than just kegels.
  • What can I do about incontinence?
  • What is pressure management and why is it important?
  • What’s a prolapse? And do I need surgery?
  • What’s all the fuss about constipation?
  • …. And much more!

Who is Jennafer Vande Vegte MSPT, BCB-PMD, PRPC?

After graduating from Ithaca College, Jennafer began her career as a physical therapist at Spectrum Health in Grand Rapids, MI. Since 2002 Jen has focused her professional attention on treating women, men and children with pelvic health disorders. She is energized through education and enjoys her position as adjunct faculty at Grand Valley University, speaking at community events, organizing a regional pelvic floor mentorship and study group, and didn’t necessarily enjoy but survived part time home schooling her two daughters. She has been faculty for Herman and Wallace Pelvic Rehabilitation Institute since 2009 and loves to inspire other rehab professionals treating pelvic floor dysfunction. She is an author of the chapter, “Manual Therapy for the Pelvic Floor” which was published in the book, “Healing in Urology.” Jen was a contributing writer for the Pelvic Floor Capstone and Oncology and the Pelvic Floor for Herman and Wallace and also co-authored the continuing education course, “Boundaries, Self-Care and Meditation” with Nari Clemons. She is certified in pelvic floor rehabilitation and biofeedback for pelvic floor disorders. Outside of teaching and treating patients, Jen loves to spend time with family and friends, run, cook, travel, do yoga and snuggle with her doggo.

Why solutions for stress urinary incontinence are outdated and archaic

The market for stress urinary incontinence (SUI) solutions has undeniably seen a history of underinvestment and underdevelopment. Femtech is currently growing at unprecedented rates as the result of women’s healthcare being characterized as under-funded, under-researched and insufficient for several years1. A lack of innovation has partly been driven by a lack of confidence from women in expressing their concerns around their own health, especially when it comes to embarrassing and taboo issues like urinary incontinence. We often hear from many physicians that women do not even feel comfortable raising the issue of SUI with their doctors, let alone their friends. It is only in recent years, that we have seen an openness from women to talk about common health issues like menstruation, urinary incontinence, or post-partum issues. Lack of communication surrounding the issue has hidden it from mainstream focus, and likely contributed to the lack of innovation in the space.

traditional solutions for SUI fall short plain and simple

SUI was hardly a matter of discussion (or even relative concern) for physicians prior to the 20th century. In fact, many issues concerning women’s health were neglected or considered taboo for much of the course of history. Early attempts at correcting urinary leakage included rudimentary belts that supported cloth underwear, external bags made of pig bladder tissue (!), and milkweed leaves as undergarments. Even well into the 1900s, technology had not progressed past the use of folded linen cloths, tucked into undergarments and washed with clothes. Today, we know that as many as 1 in 2 women will experience some form of urinary leaking in their lifetime, particularly at age 45 and older – and half of those women experience SUI.2 Incontinence is not only a normal condition, it’s incredibly common.

A great parallel can be drawn between the evolution of menstrual products and the conception and development of aids for urinary incontinence. Historically, menstrual hygiene solutions were mostly left for women to solve on their own. The same is true of urinary incontinence – many of the same primitive techniques for menstrual hygiene management were used to “treat” SUI.

Early menstrual hygiene solutions came from the Ancient Greeks, who created the world’s first tampons out of bits of wood and lint, and the Ancient Egyptians, who fashioned the world’s first absorbent pads out of softened papyrus. Despite these early versions of pads and tampons, thousands of years passed before significant innovations were made in menstrual hygiene. As the rest of the world modernized itself, stigmas and taboos concerning women’s health stayed stuck in the Dark Ages. At the turn of the 19th century, as new light was shed on the importance of cleanliness, crude cloth pads and aprons were finally produced and marketed publicly. Though an important step forward, the treatments for SUI even as little as 100 years ago seem primeval and almost satirical in hindsight.

Feminine Hygiene Products in the early 1900s

Contraptions like these were very commonly used in the early 1900s for periods and incontinence. Made of cloth and leather straps, they had to be washed frequently to avoid odour.

As time went on, companies like Kotex and Johnson-Johnson realized the need for absorbent, disposable pads, in lieu of bulky undergarments resembling an odd form of medieval punishment. Women were now able to use and dispose of pads more frequently without needing to wash them. The development of disposable, discreet pads provided much-needed relief from bulky, unhygienic cloth belts and aprons. For the first time, ads in papers and catalogues could be found for women’s health products. The stigmatic, taboo nature of women’s hygiene was slowly beginning to normalize.

But even the rapid development and marketing of disposable pads didn’t provide a feasible solution to urinary incontinence. Pads absorb leaks, but they don’t stop them from happening. They’re fairly high-maintenance, and active women can’t always find time to change them as frequently as they’d like, leaving them damp, uncomfortable, and with odour. As with most disposable goods, pads end up in landfills, so they’re not environmentally-friendly either. With a cumulative cost of US$1000+ per year, there is clearly a need for a more cost-effective, modern, innovative solution for SUI.

As we moved into the latter half of the 20th century, the advent of the pessary – a kind of device that is inserted into the vagina to support the urethra and bladder wall – provided a new alternative to SUI management. Rather than having to change and dispose of pads several times per day, pessaries helped to prevent leaks before they happened. Surgeries to correct incontinence were becoming more common, but were reserved for more extreme cases. Traditional pessaries took on a ring-like shape, while later developments assumed a host of different styles.

Vaginal Pessaries Vaginal Pessaries

Traditional pessaries are required to be inserted, cleaned, and removed by a physician. As a result, women must visit their physician up to 4 times per year. Pessaries can also often get dislodged from original placement, requiring further physician visits.

Traditional pessaries are not free from shortcomings. Though they showed merit in treating SUI, they had to be fitted by healthcare professionals, which can be an invasive and uncomfortable experience that prevents many from undertaking it. Many pessaries are meant to be replaced every 1-3 months, requiring recurring visits to clinics for fittings and check-ups. Considering the cost of not only purchasing new devices, but repeated clinic visits, pessaries can be just as expensive as pads on a yearly basis.

Today, women seeking relief from urinary incontinence face a host of treatment options. One end of the spectrum offers non-invasive, passive treatment, in the form of pads and diapers. The other end sees surgical procedures, both expensive and invasive. A more middle-of-the-pack alternative was born with the invention of the traditional SUI pessary, but are inconvenient as they require frequent physician visits. Seeing this, urogynecologist Dr. Scott Farrell set out in the early 2000s to improve pessary technology, with a focus on self-management. Dr. Farrell recognized the importance of offering effective SUI solutions that were both effective and accessible. Uresta, a self-managed, reusable, and innovative device designed to stop leaks before they happen, was created.

Uresta, the only self-managed pessary for stress urinary incontinence

Uresta allows women to have full control over their ability to manage stress urinary incontinence. A range of sizes allows women to find the one that best suits them, without needing to be fitted by a physician. The handle allows for simple insertion and removal by the woman.

Previously, the breadth of self-managed treatments was mostly limited to pads, Uresta fits like a tampon and lasts for up to a year. Uresta stops or significantly reduces bladder leaks associated with SUI verses absorbing them like pads. Uresta is one of the most exciting new products in women’s health; not only for its effectiveness in preventing physical symptoms, but for its power in improving quality of life. Ongoing SUI is not only an issue of discomfort and inconvenience, but of overall well-being. Left untreated, SUI can lead to anxiety and depression3-5. Allowing women to take control of their own treatment, devices like Uresta break down the barriers facing those who seek to regain their confidence and overcome SUI on their own.

As mentioned, advances in solutions for menstrual hygiene have often trigged advancement in solutions for managing stress urinary incontinence. We’ve seen a shift in the last decade towards from pads to tampons and to menstrual cups (e.g. DivaCup, FLEX, Nixit, Lena, Saalt, etc.) . Younger women are adopting menstrual cups at a much faster rate than their older counterparts. As these younger demographics progress in age, have children, and develop SUI are, understandably, shocked at the prospect of reverting to using pads as “treatment”. Absorbent pads seem rather arcane, especially compared to the innovation we’ve seen in the adjacent market for menstrual products. The need for a better solution for SUI has never been more apparent.

Women today are more empowered to speak up about their health concerns. The normalization of discussions concerning women’s health have allowed people who struggle with SUI to seek better alternatives and ditch the status quo. Traditional solutions for SUI fall short, plain and simple. The switch to better alternatives for managing SUI is long overdue. In the same way that we look back on arcane treatments for SUI with disdain, we must recognize that many products on the market today are simply newer versions of technology that are thousands of years old. Every woman deserves to live life, leak-free, and we truly believe Uresta is the revolutionary solution the stress urinary incontinence market desperately deserves.

  1. https://www.gminsights.com/industry-analysis/femtech-market
  2. The Canadian Continence Foundation; 2014
  3. Bogner HR, Gallo JJ, Sammel MD, Ford DE, Armenian HK, Eaton WW. Urinary incontinence and psychological distress in community-dwelling older adults. J Am Geriatr Soc 2002; 50:489-95.
  4. Meade-D’Alisera P, Merriweather T, Wentland M, Fatal M, Ghafar M. Depression symptoms in women with urinary incontinence: a prospective study. Urol Nurs. 2001; 21(6): 397-399.
  5. Coyne KS, Wein AJ, Tubaro A, et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 (S3): 4-11.