Most patients do not bring this up at a routine physical. They mention the knee, the blood pressure, and the trouble sleeping, and then they get to the parking lot and remember what they actually wanted to ask.
Urinary leakage is one of the most underreported problems in medicine. Not because it is rare, but because appointments are short and the subject feels awkward when a clock is running. At Shore View Personalized Medical Care in Lewes, DE, Dr. Uday Jani built a concierge practice specifically, so visits do not work that way. Longer appointments exist for exactly these conversations.
Here are the questions patients most often ask before their first treatment.
Key Takeaways
- Emsella is an FDA-cleared treatment for urinary incontinence that strengthens the pelvic floor while you sit fully clothed, with no surgery, medication, or downtime.
- One session delivers thousands of pelvic floor contractions, far more than Kegels can produce, and without depending on correct technique.
- It helps women after childbirth or menopause, men after prostate surgery, and older adults whose pelvic floor has weakened with age.
- Urinary symptoms are not always a pelvic floor problem, which is why Dr. Jani evaluates medications, labs, and history before recommending treatment.
- Most patients notice improvement partway through the series, with results continuing to build for weeks afterward.
1. The Basics
What is Emsella?
Emsella is an FDA-cleared treatment for urinary incontinence that strengthens the pelvic floor without surgery, medication, or undressing. You sit fully clothed on what looks like a chair while the device sends high-intensity focused electromagnetic energy through the seat, triggering thousands of pelvic floor contractions in a single session.
The pelvic floor is a sling of muscles that supports the bladder, bowel, and reproductive organs. When it weakens from childbirth, aging, prostate surgery, or hormonal change, the symptoms show up as leaking with a cough, sudden urgency, or waking repeatedly at night. Emsella addresses that muscle directly rather than managing the symptom.
How does Emsella work?
The technology is called HIFEM, and it does something voluntary exercise cannot. A Kegel contracts part of the pelvic floor for a second or two, and studies on technique consistently find that many patients are not contracting the right muscles at all.
Emsella removes technique from the equation. The electromagnetic field stimulates the entire pelvic floor at once, and one session delivers what would take months of correctly performed exercises. The muscle responds as any muscle does to training, and better support means better bladder control.
Who is Emsella for?
The treatment is often assumed to be for women after childbirth. That is one group among several. Emsella can be a good fit for:
- Women after pregnancy and delivery: Childbirth weakens the pelvic floor, and many women assume the leaking will fade with time. For a lot of them, it never does.
- Women in perimenopause and menopause: Declining estrogen thins tissue and weakens pelvic floor muscles. Many women who never had a problem develop one in their 50s.
- Men after prostate surgery: Stress incontinence is a common outcome of prostate removal. Emsella strengthens the same muscles the surgery disrupted, without any invasive procedures.
- Older adults generally: Pelvic floor strength declines with age, as with every other muscle.
- Anyone whose leakage has changed their habits: knowing where every bathroom is before you leave the house, skipping the exercise class, avoiding the beach. These adjustments happen gradually enough that people stop noticing they have made them.
If you see yourself in any of those, the next question is what is actually causing it, which is where the consultation starts.
2. Before and During Treatment
What happens during a treatment?
The appointment itself is uneventful, which is much of the appeal. You sit in the chair fully clothed, and the session lasts roughly half an hour. You will feel a tingling and a distinct contracting sensation, unusual at first and not painful.
Most patients read, answer emails, or talk through the session. Some find it a genuinely restful half hour, which is not something people expect going in. There is no downtime. You get up and continue your day.
Do I have to undress?
No, you stay fully clothed the whole time. Pelvic floor concerns often go unaddressed for years because the other options felt invasive, and plenty of patients who avoided everything else are willing to sit in a chair for half an hour.
Does Emsella hurt?
No. You will feel contractions and a tingling sensation across the pelvic floor. Most patients settle into it within the first few minutes. The intensity is adjustable, so it can be dialed back at any point.
How many sessions will I need?
The standard protocol runs several sessions across a few weeks, typically twice weekly. Improvement often begins after the first two or three sessions and continues to build for weeks after the final session as the muscle strengthens. Dr. Jani will walk you through the full series at your consultation so nothing about the commitment is a surprise.
3. Comparing Your Options
How does it compare to medication?
Anticholinergics and beta-3 agonists can reduce urgency. The tradeoffs are side effects like dry mouth and constipation, cognitive concerns in older adults, and the fact that stopping the medication means the symptoms return. Emsella strengthens the muscle, so the improvement holds without a daily pill.
Should I try physical therapy instead?
Pelvic floor physical therapy has solid evidence behind it. It requires consistent appointments over months and is not universally available. Emsella and physical therapy are frequently used together rather than as alternatives.
What about surgery?
Sling procedures work well for the right patient. They are also surgery, which means anesthesia, recovery time, and permanently implanted material. Emsella sits between doing nothing and doing something invasive, a place where many patients actually are.
Will it help with urgency, or only leaking?
Both, in many cases. A stronger pelvic floor generally improves control, though urgency has more potential causes and is worth investigating specifically.
Could something else be causing my symptoms?
Possibly, and it is worth asking before you treat anything. Urinary symptoms are not always a pelvic floor problem. They can also stem from:
- A urinary tract infection
- An enlarged prostate
- Poorly controlled blood sugar
- Medication side effects, particularly diuretics and some blood pressure drugs
- Prolapse or neurological conditions
Treating the muscle while missing the actual driver does not help anyone.
What if Emsella is not the right answer for me?
Then you should know that before you start, which is the point of a real evaluation.
As a board-certified internal medicine physician practicing integrative and functional medicine, Dr. Jani reviews your medications, your history, and your labs before recommending anything. Sometimes Emsella is the answer. Sometimes it is part of the answer alongside hydration changes, medication adjustments, or hormone evaluation. Sometimes the finding is something else entirely.
4. Results, Cost, and Safety
When will I see results?
Results typically last for several months to a year. The pelvic floor is a muscle, and muscles detrain without use, so many patients return periodically for maintenance sessions. Keeping up with pelvic floor exercises at home significantly extends results.
Is Emsella covered by insurance?
Generally not, since most carriers classify it as elective. Pricing depends on the number of sessions in your plan.
What is worth weighing against the cost is the cost of incontinence you already incur. Protective products add up over years, and so does avoiding the things you used to do without thinking about them.
Who should not have Emsella?
Anyone with metal implants in the pelvic region, a pacemaker or other implanted electronic device, an IUD in some cases, or who is pregnant. Certain other medical conditions may also make it unsuitable, and some symptoms warrant investigation before treatment rather than after. Dr. Jani reviews your full history before making any recommendations.
Why Patients Choose Shore View
What sets this practice apart is time. Shore View is a membership practice with a limited patient panel, which means longer visits and room for the conversations that get skipped everywhere else.
It also means the recommendation accounts for everything else going on. Your medications, your labs, your history. That is a different starting point than a practice that owns the equipment and stops there.
Dr. Jani is board-certified in internal medicine and practices where traditional, integrative, and functional medicine meet. Delaware Today has named him a Top Doctor twice over, in both integrative medicine and internal medicine.
See If Emsella Is Right for You
Bladder leaks and pelvic floor changes are common, but you do not have to keep planning your day around them. Dr. Jani can help you understand what is causing your symptoms and whether Emsella makes sense for you. There is no pressure to move forward at the consultation, and no expectation that you have already decided anything.
As a leading provider of Emsella in Lewes, DE, Shore View Personalized Medical Care is proud to serve Milton, Rehoboth Beach, Milford, Georgetown, Dewey Beach, and the surrounding areas. Call (302) 684-0990 to schedule your consultation.
