Incontinence Specialist

Mirela Cernaianu, MD -  - Integrative and Holistic Women's Health

Hera Healthcare

Mirela Cernaianu, MD

Integrative and Holistic Women's Health & Minimally Invasive Aesthetic Center located in Westlake Village, Thousand Oaks, CA

Women with urinary incontinence often stay silent about their condition, either because they figure it’s a natural part of aging or they’re embarrassed. If you have incontinence, you’re one of the 25-45% of women who struggle with the condition. It’s a problem often successfully treated by Dr. Mirela Cernaianu at Hera Healthcare, so please don’t wait to come in for help. Contact her office in the Westlake Village area of Thousand Oaks, California, or schedule an appointment online so you can learn about the diverse treatments available.

Urinary incontinence Q & A

What is urinary incontinence?

Urinary incontinence -- accidental urine leakage -- may be an occasional, slight problem, or it can become a severe health condition. 

What are the types of urinary incontinence and how you can tell the difference?

The two most common types of urinary incontinence are:

Stress incontinence: if you are leaking when coughing, sneezing, laughing, lifting something heavy, jumping, running or with physical activity in general then you have stress urinary incontinence.  About 50% of all women who experience urinary leakage have this condition.


What causes this type of leakage?

  • Weakening of the tissues and muscles that support the urethra and the bladder, most commonly related to childbirth trauma. 
  • Pelvic organ prolapse: Pelvic floor muscles that support the bladder weaken, and organs may drop towards the vagina

Therapies known to help Stress urinary incontinence 


  • Laser cryogen tip and RF combo like Viveve - a painless, noninvasive vaginal tightening procedure that can rejuvenate your vaginal area and boost sexual health. Volumetric radio frequency is delivered (90J/cm²) 3-5mm into vaginal tissue, thus improving blood circulation. Radio frequency then repairs and stimulates the body’s natural collagen formation. The best result is achieved three months later. Viveve provides a safe and comfortable single session that lasts about 30-45 min. 


  • Transvaginal tape procedures
  • Laparoscopic bladder suspension
  • Surgery to restore pelvic floor muscles and insert sling

Urgency incontinence, or overactive bladder: Urine leaks when you have a strong urge to urinate. If you are leaking on the way to the bathroom, or right after you have a strong urge to void then you likely suffer from urge urinary incontinence (about 20-25% of all women with urinary leakage have this condition)

Whereas Stress urinary incontinence is mainly due to pelvic floor tissue and muscles weakening there are many causes that contribute to overactive bladder/bladder spasms.  

  • Your brain may not send the proper signals telling you it’s time to urinate, or nerves that control bladder muscles may not work. 
  • Muscles that hold in urine or that support the bladder may weaken. Bladder muscles may contract too much or not enough, due to problems in the muscles or nerves.
  • Menopause: Less estrogen causes deterioration of bladder lining
  • Hysterectomy: Removing the uterus may affect pelvic floor muscles
  • Age-related changes: Bladder muscles weaken and involuntary bladder contractions increase
  • Childbirth: Vaginal delivery might have affected muscles and nerves used for bladder control

Therapies known to help Urge incontinence


  • Exercises to strengthen pelvic floor muscles
  • Bladder training
  • Lifestyle modifications and fluid intake changes 
  • Biofeedback TENS at home use device – ATTAIN*
  • LED light activate vaginal health in home use device
  • Medications


Mixed urinary incontinence

  • You have both stress and urge incontinence.
  • You would benefit from a combination of therapies or addressing the cause 

Other types of urinary incontinence include 

  • overflow incontinence
  • functional incontinence
  • transient incontinence, which is temporary because it’s caused by medications or a condition like a urinary tract infection.

Following a thorough examination to determine the underlying cause of your urinary incontinence, Dr. Mirela Cernaianu may recommend one of the above treatments.

*ATTAIN device details 

How does the ATTAIN® biofeedback device treat urinary incontinence?

ATTAIN is a medical device used to treat stress, urge, and mixed urinary incontinence in women. The device is inserted into your vagina and used to help strengthen some muscles and to relax overactive bladder muscles.

ATTAIN therapy achieves results using these techniques:

  • Inflates to provide resistance to muscles
  • Voice-guided exercise program tells when to contract and relax muscles
  • Visual biofeedback shows whether you’re holding muscle contractions long enough
  • Ensures muscles relax to avoid constant contraction
  • High frequency electrical stimulation triggers full muscle contraction
  • Low frequency electrical stimulation relaxes bladder muscle spasms

You use ATTAIN at home, where each session lasts about 12 minutes. You should use ATTAIN six days per week for about 10-14 weeks to resolve urinary incontinence, then once or twice a week for long-term maintenance. ATTAIN might be covered by your health insurance plan. InControl medical guarantees their product as illustrated in this link