Urinary Leakage/Incontinence

It can feel embarrassing to reveal that you suffer from urinary leakage, but this is a common condition women experience. Let’s learn more about it and what treatment options are available from Dr. C at HERA Healthcare.

Urinary Incontinence FAQ

What is urinary incontinence?

Urinary incontinence accidental urine leakage may be an occasional, slight problem, or it can become a severe health condition.

What are the types of urinary incontinence and how you can tell the difference?


The two most common types of urinary incontinence are:

Stress incontinence: if you are leaking when coughing, sneezing, laughing, lifting something heavy, jumping, running or with physical activity in general then you have stress urinary incontinence.  About 50% of all women who experience urinary leakage have this condition.

What causes this type of leakage?

  • 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
  • Post menopause as estrogen loss affects the health of tissues in the pelvic and vaginal area

    Urgency incontinence, or overactive bladder: Urine leaks when you have a strong urge to urinate. If you are leaking on the way to the bathroom, or right after you have a strong urge to void then you likely suffer from urge urinary incontinence (about 20-25% of all women with urinary leakage have this condition)

    Is it an Overactive Bladder?

    Do you need to know where the next bathroom stop is and always need 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 for a few minutes? Then you likely suffer from OVERACTIVE BLADDER (possibly Interstitial Cystitis). Please keep reading as you will find solutions for your problem.


    Whereas Stress urinary incontinence is mainly due to pelvic floor tissue and muscles weakening there are many causes that contribute to overactive bladder/bladder spasms.

    • 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


    Therapies Known to help Urge Incontinence

    • 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 NON-INVASIVE Treatments for Urinary Leakage and Incontinence

    Incontilase Fotona


    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
    • It is 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

    A series of 3-5 treatments is required – it will depend on the severity of the symptoms being treated 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.


    This has a “smooth mode” that allows it to penetrate deeper than most other lasers. This is a Er:YAG treatment modality that delivers laser energy onto the vaginal in a fast sequence of low fluence laser pulses inside an overall super long pulse of 200-300 mili seconds. this causes a gentle heating of the tissue without any ablation.





    How does IncontiLase® work?

    The 2940 nm Er:YAG laser used for IncontiLase® features a built-in proprietary technology called Fotona SMOOTH® that enables delivery of precisely controlled laser-induced thermal effects that stimulate collagen neogenesis and remodeling in the mucosa tissue (in the region of the vestibule and urethral orifice, as well as in the area 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 and the return of normal continence function.



    The patient will be provided with the speculum at the first session and she will be expected to bring it for every session. The cost of replacement is $150.

    The cost of FOTONA is $750/treatment

    The cost of a package series is $2000 for 3 treatments or $2500 for 5 treatments.



    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 area that is treated.

    Viveve is a painless, noninvasive vaginal tightening procedure that can make your vaginal area feel rejuvenated and can boost sexual health. Volumetric radio frequency is delivered (90J/cm²) 3-5mm into vaginal tissue, thus improving blood circulation. Radio frequency then repairs and stimulates the body’s natural collagen formation.


    Viveve Benefits

    • 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


    The best result is achieved three months later. The collagen stimulation starts from the moment the procedure is performed and the body will respond to the treatment by continuing to make new collagen and remodel the existing one, allowing tissues to tighten and lift and improving the much-needed support of the lower bladder and the urethra, that are responsible for improvement in urinary control and sexual satisfaction. Do not expect major changes to happen until about 6-10 weeks after the procedure. The body will continue to respond and 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 min.

    An annual maintenance treatment is required at 12-18 months to maintain the benefits of the procedure.

    The procedure is not covered by insurance, but patients can use their HAS cards to pay for it.

    • Current price is $2500. Touch up after 6 months if partial improvement obtained will cost $650 and must be completed within 12 months from 1st


    • We value loyalty – Annual maintenance price for returning patients is $1800.

    Tempsure Vitalia

    How does TempSure Vitalia work?


    TempSure Vitalia is the latest FDA-cleared radiofrequency (RF) system designed specifically to enhance women’s wellness. When inserted into your vaginal canal and moved around your external labial skin, the system’s small probe sends out waves of monopolar RF energy to gently heat delicate tissue.

    As tissue temperatures rise, blood circulation increases in the area. Cells think that an injury is occurring and quickly start regenerating and building new tissues. Over time, as you follow your personalized TempSure Vitalia treatment plan, fresh, new, firm tissue starts to replace the damaged tissue in and around your vagina, which ultimately resolves many of the uncomfortable (and embarrassing) issues you may be experiencing.

    How long does it take to have results after TempSure Vitalia?

    Dr. Cernaianu finds that most women who have TempSure Vitalia treatments start noticing benefits within a few days. While no downtime is needed afterward, you might experience some mild inflammation or swelling, due to the increase in blood circulation and tissue coagulation. Once these side effects fade away and new tissues start forming, you can experience sometimes dramatic benefits within 2-4 weeks.

    Do I need more than one TempSure Vitalia treatment?

    You’re probably going to experience results after a single TempSure Vitalia session. But in most cases, Dr. Cernaianu recommends having 3-5 TempSure Vitalia women’s wellness treatments to help with more complex skin laxity concerns. To ensure your improved intimate health continues to last, Dr. Cernaianu also recommends coming into Hera Healthcare once or twice a year for maintenance TempSure Vitalia treatments.

    Find out if TempSure Vitalia women’s wellness is right for you by booking a consultation at Hera Healthcare. Schedule online or over the phone.

    Individual results may vary.


    Tempsure Vitalia

    What can TempSure Vitalia treat?

    TempSure Vitalia is ideal for minimizing all kinds of problems women face because of pregnancy and menopausal hormonal fluctuations. It’s even ideal for reducing issues that you may have inherited and have lived with your entire life. This revolutionary, minimally invasive in-office treatment can:

    • Decrease involuntary bladder leakage
    • Tighten and firm loose vaginal skin
    • Restore vaginal mucosa to resolve vaginal dryness

    This innovative treatment improves your overall intimate wellness and can even help minimize issues with pain during intercourse, all without hormones or invasive surgical procedures.




    Cost:The cost of 1 VITALIA Treatment is $650.

    The cost for a series of 3 is $1800 and a series of 5 is $2500.


    How does the ATTAIN® biofeedback device treat urinary incontinence?


    ATTAIN is a medical device used to treat stress, urge, and mixed urinary incontinence in women. The device is inserted into your vagina and used to help strengthen some muscles and to relax overactive bladder muscles.

    ATTAIN therapy achieves results using these techniques:

    • Inflates to provide resistance to muscles
    • Voice-guided exercise program tells when to contract and relax muscles
    • Visual biofeedback shows whether you’re holding muscle contractions long enough
    • Ensures muscles relax to avoid constant contraction
    • High frequency electrical stimulation triggers full muscle contraction
    • Low frequency electrical stimulation relaxes bladder muscle spasms

    You use ATTAIN at home, where each session lasts about 12 minutes. You should use ATTAIN six days per week for about 10-14 weeks to resolve urinary incontinence, then once or twice a week for long-term maintenance. ATTAIN might be covered by your health insurance plan. InControl medical guarantees their product as illustrated in this link.


    How does the ATTAIN® biofeedback device treat urinary incontinence?


    ATTAIN is a medical device used to treat stress, urge, and mixed urinary incontinence in women. The device is inserted into your vagina and used to help strengthen some muscles and to relax overactive bladder muscles.


    Cost: $495. We require payment upfront when device purchased and we bill your insurance if in-network or we can help you bill insurance yourself.

    MonaLisa Touch

    How does the MonaLisa Touch restore vaginal and urinary health?


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


    The laser stimulates production of new collagen and elastin in the vaginal wall, and increases blood flow in vaginal tissues. As a result, vaginal tone, texture, and lubrication improve, normal function is restored, and vaginal atrophy symptoms like dryness, painful sex are relieved. More so, frequent UTIs, urinary frequency and urgency or the need to go to the bathroom improve to the point where quality of life is significantly improved. Usually 85-95% of women treated  with MONALISA TOUCH notice relief from all urinary leakage caused by urgency and resolution of leakage caused by mild stress urinary incontinence.


    What should you expect during and after MonaLisa Touch treatment?

    The laser treatment lasts only about five minutes and doesn’t require anesthesia, because it’s well-tolerated by most women. You may experience slight redness or swelling after the procedure, but you won’t need downtime to recover.

    Tempsure Vitalia


    How Much Does MonaLisa Touch Cost?

    Cost of MLT treatments are $700/treatment or $1900/3 sessions.

    If after a 3-treatment package improvement is 50% or short-lived, then 2 additional treatments will be recommended and will cost $225 for the 4th and $200 for the 5th treatment.

    For returning patients maintenance treatment cost is $550. You can book a treatment online now.

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