POSTED UNDER ThermiVa REVIEWS
Very Temporary Results
ORIGINAL POST
I chose this treatment hoping to improve the mild...
49in2017December 12, 2015
$1,500
I chose this treatment hoping to improve the mild stress incontinence that I've had for about ten years. After my first treatment, I came home and jumped on the trampoline and was dry (though I still felt the urge to "hold tight"). I tried jumping jacks and making myself sneeze (with black pepper) and I was still dry, so I assumed it worked well enough. I really thought this was the best thing. Then a couple of weeks go by and a sneeze later and I was running to the restroom to stop the leaking. So then I had the second of the three treatments a couple of weeks later. Once again, I could sneeze and jump without leaking. A couple of weeks go by and the effects are wearing off again. So I scanned the reviews of this treatment to see if anyone else was experiencing what I am. I then came across Dr. Gitt's writing here on RealSelf abouyt this treatment: " it is unlikely that ThermiVa will help with any vaginal issues in a lasting way.. This technology is not able to raise tissue temperatures sufficiently to promote new collagen growth (Neocollagenesis), which is necessary for any lasting results. It has been shown that Neocollagenesis occurs ONLY when the tissues are heated to 60-70C. ThermiVa absolutely does not heat tissues to 60-70C, but only achieves perhaps 45-55 degrees Celsius. By heating the vaginal lining tissues, ThermiVa causes swelling, or edema."
So the "results" that I immediately experienced were from the swelling of heating the tissues, so it makes sense that once my swelling had subsided, the incontinence returned.
So the "results" that I immediately experienced were from the swelling of heating the tissues, so it makes sense that once my swelling had subsided, the incontinence returned.
Replies (19)
December 13, 2015
I'm sorry to hear of your disappointing results with your ThermiVA treatment.
ThermiVA is a new treatment using temperature controlled radio frequency to alter tissue dynamics in the vulvo-vaginal area. As a new treatment many years of data is not yet available, however, a large body of clinical evidence is gathering supporting its use for vulvo-vaginal issues such as atrophy, pain with sex, and urinary symptoms. Of note no adverse events have been reported. We have now treated over 40 women with ThermiVA at our center and have had excellent results with appropriately selected patients. Based on your description you have significant stress urinary incontinence. You need an appropriate work up by a urogynecologist and I am confident your issue will be resolved. ThermiVa is not effective for more severe incontinence. Further, While I'm sure Dr. Gitt is a competent plastic surgeon and has a basic understanding of radio frequency treatment he has no experience in gynecology, urogynecology, or treatment of female incontinence and, therefore, has no basis to comment on this treatment. His opinion is also biased as a user and public advocate of Femilift, a competitive laser product.
My advice: Be careful what you read on line and obtain a proper evaluation.
Nathan Guerette, MD, FPMRS, FACOG, FAAFP
Director and CEO, The Female Pelvic Medicine Institute of Virginia
ThermiVA is a new treatment using temperature controlled radio frequency to alter tissue dynamics in the vulvo-vaginal area. As a new treatment many years of data is not yet available, however, a large body of clinical evidence is gathering supporting its use for vulvo-vaginal issues such as atrophy, pain with sex, and urinary symptoms. Of note no adverse events have been reported. We have now treated over 40 women with ThermiVA at our center and have had excellent results with appropriately selected patients. Based on your description you have significant stress urinary incontinence. You need an appropriate work up by a urogynecologist and I am confident your issue will be resolved. ThermiVa is not effective for more severe incontinence. Further, While I'm sure Dr. Gitt is a competent plastic surgeon and has a basic understanding of radio frequency treatment he has no experience in gynecology, urogynecology, or treatment of female incontinence and, therefore, has no basis to comment on this treatment. His opinion is also biased as a user and public advocate of Femilift, a competitive laser product.
My advice: Be careful what you read on line and obtain a proper evaluation.
Nathan Guerette, MD, FPMRS, FACOG, FAAFP
Director and CEO, The Female Pelvic Medicine Institute of Virginia
December 13, 2015
I'm not sure of the classification system for stress incontinence, but I would assume that "severe" or "significant" incontinence that you assume I have would require adult diapers or at least incontinence pads, neither of which I use. I wear a panty liner daily but that is all.
December 14, 2015
Thank you for your response. Actually it is not that simple. The severity and selection of appropriate treatment has to do with closure pressures of the urethral sphincter mechanism, degree of mobility of the tissues and other factors. Only a proper urogynecologic evaluation will determine this. The good news is ThermiVA has no negative effects so all treatment options are still available to you.
December 23, 2015
I read nowhere in your above statement why Thermiva would be effective for two weeks and then gradually disappear until another treatment is done.
January 3, 2016
Hi, Almost49!
Sounds like you didn't have a proper evaluation before you were treated and Thermiva only gave you temporary relief. What type of physician treated you? From my experience, a fellowship trained urogynecologist is the right physician to see for severe stress incontinence, not a plastic surgeon.
Sounds like you didn't have a proper evaluation before you were treated and Thermiva only gave you temporary relief. What type of physician treated you? From my experience, a fellowship trained urogynecologist is the right physician to see for severe stress incontinence, not a plastic surgeon.
December 14, 2015
ThermiVa has been a godsend for urogynecology and gynecology practices worldwide since its FDA approval and release in the United States in May 2015. As with all things new and in the forefront of technology, we are learning the nuances of treating the incontinent woman with ThermiVa. ThermiVa does heat tissues to 40-45 degrees Celsius, and a bit higher, but not to 60-70 degrees Celsius. In just about all the credible literature found, this is warm enough to heat tissues without damaging them like lasers and then tighten them and cause new collagen to form. This range of temperature has many benefits such as comfort and not requiring any downtime. Blister and burn temperatures are about 55 degrees Celsius. Permanent change and tightening of tissue occurs at the higher heats like 75-80 Celsius. Those high temperatures can damage nerves permanently and can cause both short and long term pain. The magic of ThermiVa is the slow rise in temperatures that provide comfort and the longer exposure to tissue changing temperatures for 3-5 minutes or longer. The tightening effects are indeed temporary, lasting 9-12 months on the average, but it avoids surgery, pain, downtime. Lasers have more downtime and do not work as well for incontinence in my experience. Both modalities can work to reduce stress incontinence but both lasers and radio frequency will need touch ups periodically to maintain continence. Both technologies work well in mild to moderate incontinence but not for the severe type of incontinence called "Intrinsic Sphincter Deficiency." Dr. Nathan Guerette is a renown and very experienced urogynecologist and is correct in his opinions expressed. I trust his opinion. I am a urogynecologist also. I would trust a urogynecologists opinion on the matter of pelvic and vaginal issues more than a cardiologist, emergency doctor, or plastic surgeon. I would trust the opinions of a plastic surgeon over any urogynecologists when it comes to issues like tummy tucks, breast implants, nose jobs. Common sense should rule in this case.
As for your particular case, I do think you need a better workup to ascertain which type of incontinence you have. Urodynamic studies are called for in your case. A visual exam to see if you have prolapse would also help. Checking your urinary residual, your urine flow pattern, your response to cough/jump/stress, checking your urethral and bladder pressures would be very very helpful in making a diagnosis and recommending a treatment. I have done hundreds and hundreds of ThermiVa cases for women complaining of stress urinary incontinence and have found it quite beneficial and non-invasive. No need for surgery or mesh if you have mild to moderate stress incontinence. ThermiVa has worked so well in my urogynecology practice that I have focused on non-surgical urogynecology to treat most, but not all, of my patients. It has become the core of my incontinence practice because it is so very safe and does not prohibit me from doing the more invasive surgeries if the less invasive options have failed. But like all incontinence treatments, there will be failure and ThermiVa is not immune to that. In your case, a sling may have worked better if you indeed have severe stress incontinence. By the way, those who have severe stress incontinence can still benefit from ThermiVa but I have found that those patients will need more frequent follow up. The results are not just from the temporary edema but from the formation of tight and new strong collagen to support both the urethra and bladder. Dr. Guerette is correct in his opinion that you deserve a full workup. None of the non-surgical procedures work well when there is severe incontinence. Not FemiLift, or MonaLisa, or IncontiLase. For these patients the answer is often surgery such as slings and bulking agents. And those treatments still have a high failure rate. ISD is very difficult to treat and even classic slings have a higher failure rate when compared to those patients treated for mild to moderate stress incontinence. Whomever your doctor is that tried ThermiVa for you had your best interest in mind trying to avoid surgery. I would probably give the same advice and do the same procedure if my screening process had not found any risk for severe stress incontinence. Perhaps our goal now will be to educate both patient and doctor on how to pick the right patient for ThermiVa. There are many clinical trials out there now for this amazing device called Thermiva that are specifically looking at stress incontinence and overactive bladder. We all want to make sure that those who would benefit from ThermiVa get the option to try it and that those who would be marginal or poor candidates would be offered other more aggressive choices. Please see a respected urogynecologist in your area. Pick the best.
As for your particular case, I do think you need a better workup to ascertain which type of incontinence you have. Urodynamic studies are called for in your case. A visual exam to see if you have prolapse would also help. Checking your urinary residual, your urine flow pattern, your response to cough/jump/stress, checking your urethral and bladder pressures would be very very helpful in making a diagnosis and recommending a treatment. I have done hundreds and hundreds of ThermiVa cases for women complaining of stress urinary incontinence and have found it quite beneficial and non-invasive. No need for surgery or mesh if you have mild to moderate stress incontinence. ThermiVa has worked so well in my urogynecology practice that I have focused on non-surgical urogynecology to treat most, but not all, of my patients. It has become the core of my incontinence practice because it is so very safe and does not prohibit me from doing the more invasive surgeries if the less invasive options have failed. But like all incontinence treatments, there will be failure and ThermiVa is not immune to that. In your case, a sling may have worked better if you indeed have severe stress incontinence. By the way, those who have severe stress incontinence can still benefit from ThermiVa but I have found that those patients will need more frequent follow up. The results are not just from the temporary edema but from the formation of tight and new strong collagen to support both the urethra and bladder. Dr. Guerette is correct in his opinion that you deserve a full workup. None of the non-surgical procedures work well when there is severe incontinence. Not FemiLift, or MonaLisa, or IncontiLase. For these patients the answer is often surgery such as slings and bulking agents. And those treatments still have a high failure rate. ISD is very difficult to treat and even classic slings have a higher failure rate when compared to those patients treated for mild to moderate stress incontinence. Whomever your doctor is that tried ThermiVa for you had your best interest in mind trying to avoid surgery. I would probably give the same advice and do the same procedure if my screening process had not found any risk for severe stress incontinence. Perhaps our goal now will be to educate both patient and doctor on how to pick the right patient for ThermiVa. There are many clinical trials out there now for this amazing device called Thermiva that are specifically looking at stress incontinence and overactive bladder. We all want to make sure that those who would benefit from ThermiVa get the option to try it and that those who would be marginal or poor candidates would be offered other more aggressive choices. Please see a respected urogynecologist in your area. Pick the best.
December 23, 2015
I read nowhere in your above statement why Thermiva would be effective for two weeks and then gradually disappear until another treatment is done.
December 24, 2015
It takes about 2 weeks before the bloodflow is established and fibroblasts start producing new tight collagen. Takes 3 treatments a month apart for best results for mild to moderate stress Incontinence and over active bladder. Does not work as well for severe stress Incontinence and needs more frequent touch ups, up to every 2-3 months. It is not a perfect solution but a wonderful non-surgical option for the majority of patients. Those with more severe Incontinence will probably need slings. You should get urodynamic studies to see if your incontinence is severe. See Dr. Guerette's comments. He is right on.
January 27, 2016
Dr. Gitt's review is spot on. It all comes down to science. Dr. Alinsod is on the board at Thermi and did the initial clinical trials. He also has a vested financial interest in the company so I would take those comments with a grain of salt. The results are temporary and Dr. Gitt is correct, you need to heat the skin to 60-70 degree Celsius to get any form of neocollagenesis. ThermiVA or any radiofrequency device will never heat the tissue high enough, not without damaging the skin.
February 6, 2016
Not sure why having an invested interested in a company is negative? It's nice to know physicians are backing these vaginal restorative devices. FDA cleared or not, they work. Not to mention, Dr. Guerette and Dr. Alinsod are double board certified Urogynecologists who specialize in female health. Dr. Gitt is a plastic surgeon has been reprimanded by the medical board of arizona. Why should patients trust this physician? Here is a public http://azmd.gov/GLSuiteWeb/Repository/0/0/0/1/2f024663-e8ec-4fba-ac8e-307dab49f920.pdf
March 7, 2016
It's important to know because a lot of these physicians are looking for a second source of income other than their medical practice. When they're on the payroll and invested in the company they are not always be objective. He is not doing double blind studies. The science is the science and as indicated its very temporary.
March 17, 2016
Fantastic discussion with great comments from everyone. I rarely comment on these but take them to heart and use them for my personal growth. I have learned over the years to not take them too personal and to use them positively. Thought I would give my two cents worth. I believe there is a role for the scientist-clinician doctor who can come up with ideas and therapies that are unique and potentially life-changing for patients that are also less traumatic and safer than current therapies. It is all about the patient and her care, comfort, and safety. Decades of dedication and personal sacrifice and research and the ability to get ideas from inception to trials to market are all part of advancing science. None of this is "free" and no clinician should be automatically branded as greedy just because they have been able to bring something of use to the masses. Brutal criticism is part of the game and often this criticism is useful for growth and for bouncing thoughts and ideas against. With that said, I truly believe ThermiVa is a blessing for many many patients but not all. Like any laser or other technologies for feminine rejuvenation, the results are not permanent and aging continues and gravity keeps working its pull. Touch ups are needed to maintain results. ThermiVa aims to slow down that aging cycle. For many it is not all about the tightening but also for the improvements in leaky bladders, sensitivity, dryness, and pelvic prolapse. For those people the results are worth it. No device will work for everyone. Not even ThermiVa. ThermiVa is FDA cleared for dermatologic conditions and surgery. Dermatologic conditions are things such as laxity or looseness of skin, dryness of skin, insensitivity of skin, lack of blood flow of skin. ThermiVa is so much more than for just the vaginal tightening many assume it is all for. It works well for more than just that.
Certainly agree that more research and clinical studies should be done to objectively show if radio frequency or lasers work as they claim. Lots of that going on now all around the US and the world which will help advance science. So yes, lots of studies being done for incontinence, atrophy, tightening, orgasmic dysfunction, fecal incontinence, anal tightening. Since I have the most experience with the device and the science (I designed ThermiVa with a great team) I am able to come out with the Pilot Studies that can be the basis of larger IRB trials and double blind studies. I remain objective in reporting what I find but it is obvious that I favor radio frequency over laser treatments because of my decades long use of laser based systems and radio frequency which builds a bias when you see results yourself without the influence of a company. I am in a private solo practice and obviously need outside help from other amazing doctors to design and run these studies so I freely collaborate with many well respected and brilliant clinicians. Lastly, I am not an employee of Thermi and not on the payroll and all the work I do is independent and on my own. I like this because no one influences what I get to do. That is the beautiful role of the independent clinician-scientist.
Thank you for your time.
Red Alinsod, MD
Certainly agree that more research and clinical studies should be done to objectively show if radio frequency or lasers work as they claim. Lots of that going on now all around the US and the world which will help advance science. So yes, lots of studies being done for incontinence, atrophy, tightening, orgasmic dysfunction, fecal incontinence, anal tightening. Since I have the most experience with the device and the science (I designed ThermiVa with a great team) I am able to come out with the Pilot Studies that can be the basis of larger IRB trials and double blind studies. I remain objective in reporting what I find but it is obvious that I favor radio frequency over laser treatments because of my decades long use of laser based systems and radio frequency which builds a bias when you see results yourself without the influence of a company. I am in a private solo practice and obviously need outside help from other amazing doctors to design and run these studies so I freely collaborate with many well respected and brilliant clinicians. Lastly, I am not an employee of Thermi and not on the payroll and all the work I do is independent and on my own. I like this because no one influences what I get to do. That is the beautiful role of the independent clinician-scientist.
Thank you for your time.
Red Alinsod, MD
March 19, 2016
Thank you, sir. I am sorry that others may have brutally criticized you. I simply shared my experience so others would be aware that it may not work for them as it did not work for me in the capacity that I had hoped. Obviously, it has helped some as they have reported their satisfactory results here. So, I am thankful for those who pour their time and efforts, including yourself, into researching and developing procedures that could potentially aid the suffering. If, in the future, you need a participant for a study, please keep me in mind, as I am still seeking relief and hope to find it one day.
Thank you for sharing your experience. I hope you find support in the community.