Incontinence

Leaking when you laugh, cough, sneeze, or exercise is called stress incontinence. The pelvic floor is a group of muscles that support the bladder, and when those muscles stretch or weaken they lose the strength and function needed to keep the urethra closed. The usual causes are pregnancy and childbirth, the fall in estrogen at menopause, and aging tissue. It is extremely common and almost nobody mentions it, which leaves most people with it convinced they are unusual.

There is a second kind. Urge incontinence is the sudden, intense urge to urinate, and the difficulty of controlling urination once that urge arrives. These treatments are used for stress, urge, and mixed urinary incontinence, and stress incontinence is where the case for them is strongest. Many people have some of both, and sorting out which is dominant changes the plan.

If you are experiencing incontinence alongside other troubling symptoms, you should see a medical professional first, because there could be something going on of a more serious nature. For severe cases these treatments are not a replacement for medical treatment, and we will tell you if that is where you are rather than start a course that cannot get you there.

For most stress incontinence, and particularly after childbirth, we would start with EMSELLA. You stay dressed, there are no needles, there is no recovery, and within a course you find out clearly whether your pelvic floor responds to training. That answer is useful regardless of what comes next. It is also, frankly, the easiest thing to say yes to when you have spent years not raising the subject at all.

It is worth saying that properly taught pelvic floor physical therapy is genuinely effective and is not competing with any of this. These treatments work best alongside a floor you are also using correctly, not instead of one. Many people who do Kegels every day still find their workouts are not as productive as they could be, which is why technique is worth checking.

Be clear about the limits. EMSELLA is used as a supportive treatment for pelvic organ prolapse rather than a repair for it. If you are leaking heavily rather than in occasional small amounts, these are not a replacement for medical treatment, and hearing that early is better than paying to find it out slowly.

Results are also not permanent, because the causes continue. Muscle detrains, estrogen keeps falling, and time passes, so most people return for occasional maintenance sessions to hold what they gained. A consultation establishes whether your leaking is stress, urge, or mixed, how severe it actually is, and which combination is worth your time.