Incontinence Treatment

There is this one experience many women share: coughing and sneezing cause their bladders to give off some drops of urine spontaneously. Although suffering for a long time already they are ashamed of seeing the doctor for it. Why, anyway? Do you think to be the only one to be harassed by this problem?

You are fully mistaken here, because numbers of a Viennese research programme show the opposite is true: out of approximately 1300 men and women 20% of the female test persons from age 40 onwards are increasingly affected by incontinence, with 50 % being hit as they grow older. (Temml et al.: Neurol. Urodynamics 2000,19: 259-271)

It takes up to five years before until women talk about all this with a doctor. Owing to increasing life expectancy nearly 1,5 million of both men and women will be affected.


Bladders work as a functional unit based on two phases:

Phase 1: the bladder is being filled, with itself being relaxed while at the same time the pelvic floor and the sphincter are tense.

Phase 2: once micturition starts things happen the other way round. Now the urine can flow uninhibitedly. In case this balanced process becomes impaired somehow urine leakage can happen.


Varying forms of urine leakage may be:

  • forced incontinence, when the bladder needs to be emptied all of a sudden
  • stress incontinence
  • a mixed form of these two
  • special cases


Possible reasons

With age increasing oestrogen levels are decreasing continually which, in turn, cause the cervical as well as the vaginal mucosa to change in various ways.

As the thickness of the mucosa shrinks symptoms of the urge to urinate increase.

Both obesity and infections of the urinary tract aggravate the situation once these women sneeze, do sports or get up from the chair.

All this results in a health-related reduction of one’s quality of life and also gravely impairs sexuality with approximately 50% of women concerned. (Temmel et al: Eur Urol 48:622, 2005)

Concerning stress incontinence, a sudden rise in abdominal pressure (coughing, sports) cause this spontaneous urine leakage. In this case the closure pressure both of the pelvic floor and the sphincter can no longer hold back the urine, which can flow freely then.

Reasons here may be an age-linked weakness of muscles or tissue, (often in the wake of birth), anatomic changes such as prolapse of the bladder or the rectum via the vagina, but also obesity, dry cough following extensive smoking and general diseases of the respiratory tract. (e.g. COPD). By causing the abdominal pressure to rise, they all bring about the urine leakage in question.


The check-up offered follows the rules of the European Society of Urology:

  • a detailed conversation about the patient’s specific complaints (pre-existing illnesses, current medication, infections…)
  • examination of the urine
  • proceedings of micturition
  • ultra-sonic check-up of residual urine
  • vaginal check-up
  • neuro-urological examination
  • cystoscopy


Therapy options

Such can be offered according to diagnostic findings (exercises for pelvic floor, pessary therapy, surgical options)

The latest therapeutical concept for the medical treatment of incontinence is a very special one involving a lazar applied above the vagina.

The so-called FOTONA SMOOTH mode is a minimally invasive method where no tissue is removed. the connective tissue is heated instead. This heating process initiates the regeneration of collagen, which, in turn, cause the tissue to become more solid and flexible again at the same time. As the mucosa is penetrated up to 100 micro meters only, the heat produced evenly spreads in the tissue without harming its deeper layers.

This treatment is carried out ambulant, strictly follows security regulations and lasts for 25 to 35 minutes.

Possible slight as well as temporary reactions following this treatment may include redness, vaginal discharge, symptomatic urge of urine and mucosal swelling.

What patients can do here to ease them is part of the conversation prior to the therapy.


There is a significant improvement of up to 80% of incontinence parameters described in medical literature. This change for the better lasts for months without showing any major by-effects. (Blaganje et al., Eur J Obstet Gynecol Reprod Biol., 2018 May, Gambacciani et al Climacteric 2018, 21(2): 148-152)

Immediate comparison in initial studies of this method with conventional incontinence surgery does not show any differences between methods. (TVT Band) (Okui et al WJ of Urology, August 2018)