Our former CEO, Carol Chapman, talks all about feelings of shame, the lack of funding in women’s health, and how Uresta’s changing the pee-leak game.

Women-led Uresta is changing the game for people suffering from pee leaks.

Stress Urinary Incontinence (SUI) is a very common condition suffered by 1 in 3 women globally and yet, as sufferers, even today, we largely suffer in silence. SUI, commonly referred to as Light Bladder Leakage (LBL), is a common result of childbirth and is triggered when women cough, laugh, sneeze or exercise.  Many women are affected by SUI for decades, and yet are still reluctant or embarrassed to speak out, most often continuing with traditional pads or opting for surgery (most often midurethral sling, sling surgery, and mesh surgery).

 

One of my closest friends for over 30 years suffered from SUI, as did I, and we never once spoke of it despite discussing almost everything else in our lives.  She even had multiple surgeries to try and address her stress urinary incontinence and after 8 years she was still experiencing leaks. Today, both of us are successful users of Uresta bladder support and wish that we would have simply opened up about this issue years prior and been empowered to find better solutions for ourselves.  Like so many other women, she could have avoided surgery altogether.

 

I first heard of Uresta bladder support and met its inventor, urogynecologist Dr. Scott Farrell, when a former colleague introduced us for a potential marketing consulting engagement.  I immediately realized what an extraordinary product I had just been introduced to and quickly rallied a group of women entrepreneurs that I knew would be interested in investing in the business. Whether they had SUI or not, they all knew women who did, and recognized the terrible stigma and embarrassment associated with stress urinary incontinence.  It was clear to us from day one that Uresta introduced a new sense of empowerment to female SUI sufferers that was safe, comfortable, effective, non-invasive, and affordable. Gone were the days of uncontrolled leaks, urine, odour, wet pads and avoidance of outings with friends and family. While traditional pessary devices for treating SUI have been around for decades, Uresta was one of kind in that it is a self-managed pessary. Women can easily remove or insert Uresta, unlike other pessary devices which need to be removed, inserted and cleaned by a physician multiple times a year. Uresta offers the self-managed aspect of pads but the elimination of leaks and odour offered by a pessary – offering the ultimate bladder support for women.

 

Today, Uresta continues to be a game changer in female incontinence and our Company’s efforts are focused on building awareness regarding SUI and letting women know a better solution than surgery, traditional pessaries and pads exists.  Whether women are in their 30s or 60s, they truly need to know an amazing option exists that will allow them the quality of life and empowerment they deserve. Our goal is simple, to educate and inspire a growing community of women everywhere to stop allowing bladder leaks to hold them back from anything!

Promoting Uresta at a healthcare conference in 2018

 

As women entrepreneurs, we understood our approach to market needed to be credible, relevant, thoughtful, and informative, while also being bold, direct, and disruptive.  It has taken decades for women to even admit they suffer from SUI and that they deserve credible options to live their best “life without leaks”. Our conversations are multi-faceted with the goal of reaching all possible influencers, to ensure the compelling story of Uresta reaches healthcare professionals, insurers, advocate groups and most importantly women, that on average will be affected by SUI at some point in their lives.

 

Our shareholder group continues to be comprised of a number of successful and influential women; the chair of a top Canadian bank, CEO of a renewable energy company, lead partner for a global consulting firm, division head of a global pharmaceutical company, and many other successful professionals and entrepreneurs.  These champions of Uresta recognize the need for change and that women’s health globally, has been underfunded for decades.

Uresta  wins 2016 Product of the Year Canada award in the adult care incontinence category.

In early 2021, I retired as Uresta’s CEO and remain an active board member, shareholder and proud advocate for Uresta and women’s health.  As part of this transition, we were excited to bring on our new CEO, Lauren Barker, a bright accomplished young female leader who will help grow consumer awareness and introduce Uresta to more women than ever before.

 

Today’s generation of women boldly advocate for their own health and are far less embarrassed to admit they suffer from conditions such as SUI. Massive change is happening, lets be bold together.

What IS the pelvic floor and what does it DO in my body?

An Introduction to Pelvic Floor Anatomy and Function in Women & Men

The Pelvic Floor is finally starting to get the press it fully deserves in our culture.  As a Physical Therapist who specializes in pelvic health, I often see magazine articles, websites and new products being developed to help educate, empower and support pelvic floor function.

But I am willing to bet that most of us are not very familiar with the unique architecture and function of this remarkable part of our body.  Read on for an anatomy lesson on the pelvic floor and learn about all the important bodily functions it plays a key role in.

The pelvic floor complex is comprised of 10 muscles in female bodies and 8 muscles in male bodies that are formed into three layers.  The following is a tour through each of those layers’ structure and function.

Functions of Your pelvic floor muscles

  1. Supportive
  2. Sphincteric
  3. Sexual
  4. Stabilizing
  5. Posture
  6. Breathing
  7. Pumps Fluids

 

Layer 1: Muscles that support sexual and support functions

In female bodies, layer one pelvic floor muscles support the vaginal and anal openings by forming the band of tissue between the vagina and the anus (perineum).  These muscles help with blood flow to the clitoris during arousal and hug the vaginal opening.

 

Muscle of the female perineumThese muscles are often injured or torn during vaginal childbirth. 

In male bodies, layer one is also helpful for sexual functioning by maintaining erection, plays a role in urination, and provides muscular support to the area between the testicles and the anus (perineum).  Weakness in these muscles can contribute to urinary leakage and erectile dysfunction.

In both male and female bodies, the external anal sphincter is also part of layer one muscles.  The anal sphincter plays a big role in coordinating defecation.

 

 

Muscle of the male perineum

 

Layer 2: Muscles that coordinate and control urination

Female bodies are more prone to issues with urinary incontinence for several reasons:  they lack a prostate gland, have a shorter urethra, may experience the stress and strain of pregnancy and childbirth, and lose estrogen which may negatively affect continence.  Luckily, the second layer of pelvic floor muscles offers some compensation for this.  Male bodies have just two muscles here, while female bodies have four that offer additional support around closing the urethra.

These muscles may be weak, poorly coordinated, or overactive which usually presents as urinary dysfunction:  leakage, urgency, spraying, dribbling.

 

Layer 3: Muscles that support our pelvic organs

The third layer is relatively the same in both female male bodies and is busy with many functions.  These muscles provide support for the pelvic organs (bladder, urethra, rectum and prostate in male bodies; bladder, urethra, vagina, uterus, and rectum in female bodies).    They are important for sexual functioning and orgasm.  The third layer of pelvic floor muscles also join in with a network of other muscles of the body to provide postural stability, coordinate with the diaphragm (the main breathing muscle) to assist in breathing, and even form a kind of pump to help move blood and fluids from the lower body back to the heart.

 

This layer is susceptible to stretch injury from pregnancy and childbirth, weakness from chronic straining (lifting, coughing, constipation), problems from nerve damage or surgery, and structural weakness that happens with loss of estrogen.

Overactivity in this layer can occur with chronic pain, trauma, musculoskeletal problems like low back or hip pain, surgery, clenching/stress and tension, and tailbone injuries.

Levator ani structure

Your hip bone’s connected to your …

Pelvic floor view looking from above

There is one more muscle I’d like to highlight, that isn’t exactly a pelvic floor muscle but sometimes gets called part of the pelvic WALL.  This muscle is interesting and unique in that it is actually a HIP muscle and it’s job is to externally rotate and stabilize the hip joint.  BUT it literally attaches right into the pelvic floor.  Sooo your hip bone IS attached to your pelvis just like the old song says!

This image shows the view of the pelvic floor looking from above.  You can see the Obturator Internus muscle outlined in blue (with arrows) and the third layer of the pelvic floor outlined in red.

Research has found that this muscle is also an important factor in pelvic floor function and via it’s anatomy, it links hip and pelvic function.

Studies in both female and male bodies show that exercising this muscle can be just as effective as exercising your pelvic floor in relieving stress urinary incontinence or accidental urine leakage.

I bet you just got a pretty good education on a part of your body you didn’t know much about!  In our next blog we’ll talk about how problems in pelvic floor muscle function occur and the symptoms this can cause.

If you like learning, stay tuned for future blog posts covering topics like …

  • What happens when there is pelvic floor dysfunction?
  • Why pelvic health is more than just kegels.
  • What can I do about incontinence?
  • What is pressure management and why is it important?
  • What’s a prolapse? And do I need surgery?
  • What’s all the fuss about constipation?
  • …. And much more!

Who is Jennafer Vande Vegte MSPT, BCB-PMD, PRPC?

After graduating from Ithaca College, Jennafer began her career as a physical therapist at Spectrum Health in Grand Rapids, MI. Since 2002 Jen has focused her professional attention on treating women, men and children with pelvic health disorders. She is energized through education and enjoys her position as adjunct faculty at Grand Valley University, speaking at community events, organizing a regional pelvic floor mentorship and study group, and didn’t necessarily enjoy but survived part time home schooling her two daughters. She has been faculty for Herman and Wallace Pelvic Rehabilitation Institute since 2009 and loves to inspire other rehab professionals treating pelvic floor dysfunction. She is an author of the chapter, “Manual Therapy for the Pelvic Floor” which was published in the book, “Healing in Urology.” Jen was a contributing writer for the Pelvic Floor Capstone and Oncology and the Pelvic Floor for Herman and Wallace and also co-authored the continuing education course, “Boundaries, Self-Care and Meditation” with Nari Clemons. She is certified in pelvic floor rehabilitation and biofeedback for pelvic floor disorders. Outside of teaching and treating patients, Jen loves to spend time with family and friends, run, cook, travel, do yoga and snuggle with her doggo.

Why solutions for stress urinary incontinence are outdated and archaic

The market for stress urinary incontinence (SUI) solutions has undeniably seen a history of underinvestment and underdevelopment. Femtech is currently growing at unprecedented rates as the result of women’s healthcare being characterized as under-funded, under-researched and insufficient for several years1. A lack of innovation has partly been driven by a lack of confidence from women in expressing their concerns around their own health, especially when it comes to embarrassing and taboo issues like urinary incontinence. We often hear from many physicians that women do not even feel comfortable raising the issue of SUI with their doctors, let alone their friends. It is only in recent years, that we have seen an openness from women to talk about common health issues like menstruation, urinary incontinence, or post-partum issues. Lack of communication surrounding the issue has hidden it from mainstream focus, and likely contributed to the lack of innovation in the space.

traditional solutions for SUI fall short plain and simple

SUI was hardly a matter of discussion (or even relative concern) for physicians prior to the 20th century. In fact, many issues concerning women’s health were neglected or considered taboo for much of the course of history. Early attempts at correcting urinary leakage included rudimentary belts that supported cloth underwear, external bags made of pig bladder tissue (!), and milkweed leaves as undergarments. Even well into the 1900s, technology had not progressed past the use of folded linen cloths, tucked into undergarments and washed with clothes. Today, we know that as many as 1 in 2 women will experience some form of urinary leaking in their lifetime, particularly at age 45 and older – and half of those women experience SUI.2 Incontinence is not only a normal condition, it’s incredibly common.

A great parallel can be drawn between the evolution of menstrual products and the conception and development of aids for urinary incontinence. Historically, menstrual hygiene solutions were mostly left for women to solve on their own. The same is true of urinary incontinence – many of the same primitive techniques for menstrual hygiene management were used to “treat” SUI.

Early menstrual hygiene solutions came from the Ancient Greeks, who created the world’s first tampons out of bits of wood and lint, and the Ancient Egyptians, who fashioned the world’s first absorbent pads out of softened papyrus. Despite these early versions of pads and tampons, thousands of years passed before significant innovations were made in menstrual hygiene. As the rest of the world modernized itself, stigmas and taboos concerning women’s health stayed stuck in the Dark Ages. At the turn of the 19th century, as new light was shed on the importance of cleanliness, crude cloth pads and aprons were finally produced and marketed publicly. Though an important step forward, the treatments for SUI even as little as 100 years ago seem primeval and almost satirical in hindsight.

Feminine Hygiene Products in the early 1900s

Contraptions like these were very commonly used in the early 1900s for periods and incontinence. Made of cloth and leather straps, they had to be washed frequently to avoid odour.

As time went on, companies like Kotex and Johnson-Johnson realized the need for absorbent, disposable pads, in lieu of bulky undergarments resembling an odd form of medieval punishment. Women were now able to use and dispose of pads more frequently without needing to wash them. The development of disposable, discreet pads provided much-needed relief from bulky, unhygienic cloth belts and aprons. For the first time, ads in papers and catalogues could be found for women’s health products. The stigmatic, taboo nature of women’s hygiene was slowly beginning to normalize.

But even the rapid development and marketing of disposable pads didn’t provide a feasible solution to urinary incontinence. Pads absorb leaks, but they don’t stop them from happening. They’re fairly high-maintenance, and active women can’t always find time to change them as frequently as they’d like, leaving them damp, uncomfortable, and with odour. As with most disposable goods, pads end up in landfills, so they’re not environmentally-friendly either. With a cumulative cost of US$1000+ per year, there is clearly a need for a more cost-effective, modern, innovative solution for SUI.

As we moved into the latter half of the 20th century, the advent of the pessary – a kind of device that is inserted into the vagina to support the urethra and bladder wall – provided a new alternative to SUI management. Rather than having to change and dispose of pads several times per day, pessaries helped to prevent leaks before they happened. Surgeries to correct incontinence were becoming more common, but were reserved for more extreme cases. Traditional pessaries took on a ring-like shape, while later developments assumed a host of different styles.

Vaginal Pessaries Vaginal Pessaries

Traditional pessaries are required to be inserted, cleaned, and removed by a physician. As a result, women must visit their physician up to 4 times per year. Pessaries can also often get dislodged from original placement, requiring further physician visits.

Traditional pessaries are not free from shortcomings. Though they showed merit in treating SUI, they had to be fitted by healthcare professionals, which can be an invasive and uncomfortable experience that prevents many from undertaking it. Many pessaries are meant to be replaced every 1-3 months, requiring recurring visits to clinics for fittings and check-ups. Considering the cost of not only purchasing new devices, but repeated clinic visits, pessaries can be just as expensive as pads on a yearly basis.

Today, women seeking relief from urinary incontinence face a host of treatment options. One end of the spectrum offers non-invasive, passive treatment, in the form of pads and diapers. The other end sees surgical procedures, both expensive and invasive. A more middle-of-the-pack alternative was born with the invention of the traditional SUI pessary, but are inconvenient as they require frequent physician visits. Seeing this, urogynecologist Dr. Scott Farrell set out in the early 2000s to improve pessary technology, with a focus on self-management. Dr. Farrell recognized the importance of offering effective SUI solutions that were both effective and accessible. Uresta, a self-managed, reusable, and innovative device designed to stop leaks before they happen, was created.

Uresta, the only self-managed pessary for stress urinary incontinence

Uresta allows women to have full control over their ability to manage stress urinary incontinence. A range of sizes allows women to find the one that best suits them, without needing to be fitted by a physician. The handle allows for simple insertion and removal by the woman.

Previously, the breadth of self-managed treatments was mostly limited to pads, Uresta fits like a tampon and lasts for up to a year. Uresta stops or significantly reduces bladder leaks associated with SUI verses absorbing them like pads. Uresta is one of the most exciting new products in women’s health; not only for its effectiveness in preventing physical symptoms, but for its power in improving quality of life. Ongoing SUI is not only an issue of discomfort and inconvenience, but of overall well-being. Left untreated, SUI can lead to anxiety and depression3-5. Allowing women to take control of their own treatment, devices like Uresta break down the barriers facing those who seek to regain their confidence and overcome SUI on their own.

As mentioned, advances in solutions for menstrual hygiene have often trigged advancement in solutions for managing stress urinary incontinence. We’ve seen a shift in the last decade towards from pads to tampons and to menstrual cups (e.g. DivaCup, FLEX, Nixit, Lena, Saalt, etc.) . Younger women are adopting menstrual cups at a much faster rate than their older counterparts. As these younger demographics progress in age, have children, and develop SUI are, understandably, shocked at the prospect of reverting to using pads as “treatment”. Absorbent pads seem rather arcane, especially compared to the innovation we’ve seen in the adjacent market for menstrual products. The need for a better solution for SUI has never been more apparent.

Women today are more empowered to speak up about their health concerns. The normalization of discussions concerning women’s health have allowed people who struggle with SUI to seek better alternatives and ditch the status quo. Traditional solutions for SUI fall short, plain and simple. The switch to better alternatives for managing SUI is long overdue. In the same way that we look back on arcane treatments for SUI with disdain, we must recognize that many products on the market today are simply newer versions of technology that are thousands of years old. Every woman deserves to live life, leak-free, and we truly believe Uresta is the revolutionary solution the stress urinary incontinence market desperately deserves.

  1. https://www.gminsights.com/industry-analysis/femtech-market
  2. The Canadian Continence Foundation; 2014
  3. Bogner HR, Gallo JJ, Sammel MD, Ford DE, Armenian HK, Eaton WW. Urinary incontinence and psychological distress in community-dwelling older adults. J Am Geriatr Soc 2002; 50:489-95.
  4. Meade-D’Alisera P, Merriweather T, Wentland M, Fatal M, Ghafar M. Depression symptoms in women with urinary incontinence: a prospective study. Urol Nurs. 2001; 21(6): 397-399.
  5. Coyne KS, Wein AJ, Tubaro A, et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 (S3): 4-11.