Stress urinary incontinence (SUI) is urinary leakage that occurs with physical activities such as coughing, exercising, laughing, sneezing, etc. It is actually quite common, affecting 40% of women in the United States. This type of urinary incontinence tends to occur with weakened pelvic floor muscles. Your pelvic floor muscles may become weakened from childbirth, illnesses that cause chronic coughing, obesity, smoking, or long-term, high-impact activities such as running and heavy lifting. Two common, non-surgical treatment options for this type of urinary incontinence include Uresta and Poise Impressa.

Uresta

A small, bell-shaped device that is inserted into the vagina at the beginning of each day or before any activity that causes urinary leakage (running, walking, yoga). The device can be worn for the entire day or used just for certain activities. The device should be removed at the end of each day and before intercourse.

When Uresta is inserted into the vagina, it gently presses on the urethra (the tube in which urine is emptied) which improves urethral support. When the urethra is properly supported, the risk of urinary leakage with activity is greatly reduced.

“In clinical studies, 17 out of 20 women [wearing Uresta] saw a significant reduction in leaking while leaks were completely eliminated for 6 out of 10 women” (Farrell, Baydock, Amir, & Fanning, 2007).

What is it made of?

The Uresta device is made of “nonabsorbent, hypoallergenic medical-grade plastic. It is not made with natural rubber latex” and does not contain any phthalates such as DEHP (Uresta, 2020). There are five different sizes to choose from. Women should start with one of the smaller sizes first and assess for comfort and leakage. If the Uresta falls out of the vagina or urinary leakage is not greatly reduced, it is recommended to try the next size up. Uresta can be safely worn on a regularly basis for a year. After a year, it is recommended the device be replaced with a new one. Uresta requires a prescription and many health care insurance plans will cover the cost of this device.

Poise Impressa

A small, soft, flexible insert that is placed vaginally in the same manner as a tampon. It is “made from flexible, medical-grade silicone, surrounded with a soft, non-absorbent polypropylene covering…Each bladder support comes in a smooth plastic applicator and has a polyester and rayon string” (Poise, 2020). Once inserted, the Impressa provides increased support to the urethra. This additional support reduces the risk of urinary leakage during activity. While these inserts help stop leakage before it starts, they do not absorb urine if urine is leaked. Therefore, it may be beneficial to wear a panty liner while trialing the different sizes. The Impressa comes in three different sizes for optimal comfort and leak protection. It is recommended that women start with the smallest size first. If it feels comfortable and there is no leakage during activity, this is likely the right fit. If the insert is comfortable, but there is leakage with activity, the next size up should be tried.

How long can I wear it for?

The Poise Impressa can be worn for 12 hours at a time, day or night. However, it should not be worn during one’s menstrual cycle. After 12 hours of use, the Impressa should be removed and thrown away; it is NOT reusable. The Impressa is designed to stay in place with activity so it can be worn during running, swimming, exercising, biking, etc. There is no need to remove it before urinating, as it will not block urine flow. However, it should be removed before sexual intercourse. Poise Impressa inserts can be purchased online from multiple retailers; no prescription is required.

If you are looking for a non-surgical treatment option to help reduce or limit your urinary leakage, schedule an appointment with one of our urogynecology providers today.

References:

Farrell, S.A., Baydock, S., Amir, B., & Fanning, C. (2007). Effectiveness of a new self-positioning pessary for the management of urinary incontinence in women. American Journal of Obstetrics & Gynecology, 196, 474.

Poise. (2020). Frequently asked questions: What are Poise Impressa bladder supports made of? Retrieved from https://www.poise.com/en-us/products/impressa/faq/what-are-poise-impressa-bladder-supports-made-of

Uresta (2020). What is uresta made of? Retrieved from https://www.uresta.com/pages/faqs