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Angela M. Pratt

Kapi‘olani Medical Center for Women & Children, OB-GYN Department Honolulu, HI 96826
(808) 531-8878
Specialty: Obstetrics & Gynecology
Special Expertise:

Over the years after my delivery, I have noticed increasing urinary leakage with minimal activity. What can I do about it without having surgery?

You are not alone. By age 40, half of women experience urinary stress incontinence (USI) with coughing, laughing or lifting. It’s not uncommon, as vaginal tissue laxity naturally occurs with aging and especially after childbirth. As a consequence, alterations to the opening of the bladder cause involuntary urinary leakage, often resulting in embarrassing situations. Many women wear pads every day to avoid such accidents, but the constant use of pads is associated with vulvar irritation and vaginal discharge.

What have been the treatment options available?

Surgical correction using a mesh sling has always been the gold standard of treatment for USI; however, because of the controversy surrounding synthetic meshes, women, especially those with mild to moderate urinary leakage, would prefer to avoid surgery. For these women, most physicians recommend Kegel exercises to strengthen the pelvic floor muscles before considering surgery. Despite diligently doing their exercises, many patients, even those with mild to moderate USI, do not achieve complete resolution of their symptoms.

At Hawaii Beauty and Wellness Center, we can offer nonsurgical alternatives.

Using laser and radio-frequency technologies, we have successfully treated patients with complaints of vaginal laxity and dryness. The exciting news we found was that even women with mild to moderate USI experienced positive results! These patients, who didn’t get better with Kegel exercises, report resolution of urinary leakage as an additional benefit of treatment. Although these treatments are not FDA-approved for this purpose, many patients with nonsevere USI are gratified by relief of their symptoms and, most importantly, are happy to be free of daily pads.

Ongoing clinical studies are now being conducted to investigate treatments for urinary stress incontinence using these nonsurgical modalities. Because platelet-rich plasma (PRP) has shown promise in enhancing tissue regeneration and aiding in alleviating USI, research with PRP is also being explored as an adjunctive therapy.

Helping women improve their quality of life inspires us at Hawaii Beauty and Wellness Center.

We continue to explore innovative, nonsurgical technologies to treat women with urinary stress incontinence and other conditions at every age of their lives.