Stress Urinary Incontinence: Laser and Non-Surgical Options in Singapore
Leaking urine when you cough, laugh, jump or lift is common after childbirth and around menopause, and it is treatable. This guide by Dr Sin Yong, Medical Director of IN Eternity Clinic, sets out the options in the order doctors usually consider them, with the evidence for each.
Related page: feminine rejuvenation in Singapore.
WhatsApp to Enquire →Key facts ↓Stress urinary incontinence is leakage of urine with coughing, sneezing, laughing or exercise, caused by weak support around the bladder outlet. Supervised pelvic floor muscle training is the first-line treatment and helps most women. Vaginal laser and the Emsella electromagnetic chair have been studied, but the evidence is mixed and long-term data are limited. Moderate or severe leakage is assessed by a urogynaecologist or urologist. At IN Eternity Clinic in Singapore, laser is considered only alongside pelvic floor training, after assessment.
- Pelvic floor training comes first: a Cochrane review found women who did pelvic floor muscle training were far more likely to report cure or improvement than those who did not [1].
- Laser evidence is mixed: a randomised trial comparing vaginal CO2 laser with a sham treatment for stress incontinence found no significant difference between the groups [2].
- Regulators urge caution: in 2018 the US FDA warned that energy-based devices had not been cleared for urinary incontinence or vaginal "rejuvenation" [3].
- Emsella data are early: a small uncontrolled study reported improved symptoms after six sessions on a focused electromagnetic chair; controlled, long-term data are limited [4].
What stress urinary incontinence is
Stress incontinence means urine leaks when pressure in the abdomen rises suddenly: a cough, a sneeze, a laugh, a jump or lifting something heavy. It happens when the pelvic floor muscles and the tissue supporting the urethra are too weak to hold the bladder outlet closed.
- Common triggers are pregnancy and vaginal birth, menopause, long-term constipation or coughing, and high-impact sport.
- It is different from urge incontinence, where there is a sudden, strong need to pass urine. Many women have some of both.
- Leakage with blood in the urine, pain, repeated infections or difficulty emptying the bladder needs medical review first.
Treatments at a glance
| Option | What it is | Evidence | Usually suits |
|---|---|---|---|
| Pelvic floor muscle training | Supervised exercises, often with a women's health physiotherapist | Strong; recommended first-line | Almost everyone, as the first step |
| Vaginal laser | Fractional CO2 or erbium laser applied inside the vagina over several sessions | Mixed; one sham-controlled trial found no difference | Mild leakage, alongside training, after assessment |
| Emsella chair | Focused electromagnetic energy that contracts the pelvic floor while you sit clothed | Early; mostly small studies without a control group | Those who cannot do exercises effectively |
| Pessary or medication | A vaginal support device, or medicines in selected cases | Established in specialist care | Assessed by a gynaecologist |
| Surgery | Mid-urethral sling or other procedures by a urogynaecologist or urologist | Strong for moderate to severe leakage | Leakage that has not responded to other treatment |
The order matters. Devices are not a substitute for an assessment, and they are not a first step [1].
What the evidence says about laser
Vaginal lasers heat the tissue of the vaginal wall with the aim of stimulating collagen. Early studies without a comparison group reported fewer leaks. When CO2 laser was compared with a sham treatment in a randomised trial, however, both groups improved to a similar degree [2]. Regulators have also cautioned against claims that go beyond the evidence [3].
Because the evidence is mixed, IN Eternity Clinic considers vaginal laser for mild stress incontinence only alongside pelvic floor training, and only after assessment. See vaginal laser (G Lift).
How the Emsella chair compares
Emsella is a chair that delivers high-intensity focused electromagnetic energy to the pelvic floor, causing thousands of muscle contractions in a session while you remain clothed. A small study without a control group reported improvement in symptoms and quality of life after six sessions [4]. Larger controlled studies with long follow-up are still needed, so it is best seen as an aid to pelvic floor strengthening and not as a cure.
When to see a specialist
- Leakage that soaks a pad or limits exercise, work or travel.
- Leakage with a bulge or heaviness in the vagina, which can indicate prolapse.
- Urgency, frequency, pain, blood in the urine or repeated infections.
- No improvement after about three months of supervised pelvic floor training.
In these situations a urogynaecologist or urologist should assess you. Dr Sin Yong refers where needed. Results from any treatment vary between people.
Frequently asked questions
What is the first treatment for stress incontinence?
Supervised pelvic floor muscle training is the first-line treatment. Women who do it are much more likely to report cure or improvement than those who do not, and it has no side effects.
Can laser treat urinary incontinence?
Vaginal laser has been studied for mild stress incontinence, with mixed results. A randomised trial found no significant difference between CO2 laser and a sham treatment. It may be considered alongside pelvic floor training after assessment, not as a replacement for it.
What is Emsella and does it work?
Emsella is a chair that uses focused electromagnetic energy to contract the pelvic floor muscles while you sit clothed. Small early studies report improved symptoms, but controlled long-term evidence is limited.
Is leaking urine after childbirth normal?
It is common, especially in the first months, and often improves with pelvic floor training. Leakage that continues beyond three to six months, or that limits daily life, is worth having assessed.
When is surgery needed for stress incontinence?
Surgery is considered when leakage is moderate or severe and has not responded to pelvic floor training and other measures. It is carried out by a urogynaecologist or urologist after tests.
How much does stress incontinence treatment cost in Singapore?
It depends on the treatment. Physiotherapy, device-based sessions and surgery are all priced differently, and specialist tests may be needed first. At IN Eternity Clinic the plan is set out after assessment. The consultation fee is S
Book an assessment
IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, Singapore 228210. By appointment with Medical Director Dr Sin Yong. Monday to Saturday, 11am to 8pm. WhatsApp or call +65 8815 3008. At IN Eternity Clinic a consultation fee applies, and it is waived if you go ahead with any medical treatment; the fee is S
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References
- Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2018;(10):CD005654. doi:10.1002/14651858.CD005654.pub4
- Alexander JW, Karjalainen P, Ow LL, et al. CO2 surface-ablative laser for treatment of stress urinary incontinence in women: a randomized controlled trial. Am J Obstet Gynecol 2022;227(3):473.e1-473.e12. PubMed
- U.S. Food and Drug Administration. FDA warns against use of energy-based devices to perform vaginal "rejuvenation" or vaginal cosmetic procedures: FDA Safety Communication. 30 July 2018.
- Samuels JB, Pezzella A, Berenholz J, Alinsod R. Safety and efficacy of a non-invasive high-intensity focused electromagnetic field (HIFEM) device for treatment of urinary incontinence and enhancement of quality of life. Lasers Surg Med 2019;51(9):760-766. PubMed
Figures taken from the published papers and abstracts. Results vary between people; suitability is decided at an in-person consultation.