By the way, doctor

Should I try Renessa for urinary incontinence?

Q. I have stress urinary incontinence and don't want to have surgery. What can you tell me about Renessa?

A. Renessa is a procedure that uses radiofrequency waves to treat stress urinary incontinence — the kind caused by increased abdominal pressure from coughing, sneezing, laughing, lifting heavy objects, and certain recreational activities. The radiofrequency waves are delivered through a probe inserted into the urethra (the tube that carries urine from the bladder to outside the body). The probe reaches the upper urethra, near the bladder, and the heat generated by the radiofrequency waves causes the tissue in that area to scar, making it firmer and presumably more resistant to involuntary leakage.

Renessa was approved in 2005 for the treatment of stress urinary incontinence in women who aren't candidates for surgery. It requires anesthesia but takes only about 20 minutes and can be performed on an outpatient basis. Follow-up studies are encouraging: in one study, 78% of 170 women reported improvement after one year. But so far, the only published studies of Renessa have been funded by the manufacturer, Novasys Medical. Moreover, there are no long-term data on its effects. That's important, because heating the tissue injures it. While that may reduce incontinence in the short term, we don't know how patients will be faring five or 10 years down the road.

I suggest that you try other noninvasive therapies, including bladder training and Kegel exercises. If you're overweight, losing weight may also help. If these don't work, talk to your clinician about established surgical options, all of which have a longer track record than Renessa. Before recommending Renessa, I'd like to see some long-term research that isn't sponsored by the manufacturer.

— Celeste Robb-Nicholson, M.D.
Editor in Chief, Harvard Women's Health Watch