Bladder weakness treatment at Cannelle Skin Clinic in Oxford uses BTL EMSella to strengthen the pelvic floor while you sit fully clothed. Twenty eight minutes produces around eleven thousand contractions, with no undressing, nothing invasive and no downtime.
One in three women will experience this and almost none of them will say so out loud. People stop running, plan journeys around toilets and quietly accept it as the price of having had children. It is genuinely common. It is also among the most fixable things we treat.
Most of it comes down to the pelvic floor: a sling of muscle running from the pubic bone to the base of the spine that supports the bladder, bowel and uterus and helps close the urethra. Pregnancy and childbirth stretch it. The drop in oestrogen at menopause thins and weakens the surrounding tissue. Prostate surgery affects it in men. Age, heavy lifting, chronic coughing and high impact sport all contribute. When that support weakens, pressure from above is no longer resisted properly.
There are two main patterns, and they feel quite different. Stress incontinence is leaking when pressure rises: coughing, sneezing, laughing, lifting or jumping. Urge incontinence is a sudden overwhelming need to go, sometimes with leaking before you arrive. Many people have both, which is called mixed incontinence.
The NHS guidance on urinary incontinence is a sensible place to start, and we would always encourage you to speak to your GP as well. What we offer is a non invasive treatment that strengthens the pelvic floor without you having to undress or do anything at all.
These feel quite different from the inside, and the distinction matters because it changes what to expect. Many people have more than one.
Stress incontinence
A small leak when pressure rises suddenly: coughing, sneezing, laughing, lifting or running. This is the pattern most clearly caused by a weakened pelvic floor, and the one that responds best to strengthening it.
Urge incontinence
An overwhelming need to go with very little warning, sometimes with leaking before you reach a toilet. Often involves the bladder muscle as well as the pelvic floor, so it can also need input from your GP.
Postnatal
Pregnancy and delivery stretch the pelvic floor considerably, and it does not always recover on its own however diligent the exercises. Common, rarely discussed, and very treatable. We would wait until at least three months after delivery.
Hormonal
Falling oestrogen thins the tissues supporting the bladder and urethra, so symptoms often begin or worsen around this time. Worth discussing with your GP alongside treatment here, since topical hormone treatment can help too.
There is one treatment here rather than a menu. What varies is whether you take a single session or the full course, and the course is what produces the result.
| Compare | Single sessionTrying it | Course of sixThe full protocol |
|---|---|---|
 |  | |
| Best for | Single session Seeing what it is like before committing | Course of six Genuine improvement in bladder control |
| What happens | Single session Twenty eight minutes seated, fully clothed, while the chair contracts your pelvic floor for you | Course of six The same session twice a week over three weeks |
| Equivalent to | Single session Around 11,000 pelvic floor contractions | Course of six Around 66,000 contractions across the course |
| Downtime | Single session None. Drive yourself home | Course of six None at any point |
| Price from | Single session £180 | Course of six £920 |
| See EMSella | See EMSella |
You stay fully clothed and seated throughout, which is the part most people are relieved to see.
BTL EMSella is a chair. You sit on it fully clothed and it does the work that pelvic floor exercises are supposed to do, at an intensity and consistency no one could manage alone.
Fully clothed, seated
High intensity focused electromagnetic energy stimulates the entire pelvic floor, producing thousands of supramaximal contractions in a single session. You sit and read. There is nothing to undress for, nothing invasive and nothing to recover from.
Confidential and unhurried
We establish which pattern you have, how long it has been going on and whether anything points toward a cause that needs your GP first. Some people have never said any of it out loud before, and there is no rush.
Six sessions, then upkeep
Two sessions a week for three weeks. Most people notice a difference partway through, with the full benefit some weeks after finishing. A single top up session once or twice a year maintains it, alongside your own exercises.
The assessment is a conversation rather than an examination, and nothing about it requires you to undress.
We ask when it happens, how much warning you get, how long it has been going on, whether you have had children and where you are relative to the menopause. Those answers separate stress from urge incontinence and tell us how likely treatment is to help. We will ask what you have already tried, because plenty of people have been doing pelvic floor exercises incorrectly for years and a correction alone sometimes helps.
We will also tell you when to see your GP first. Blood in your urine, pain, recurrent infections, a sudden change, or symptoms alongside a prolapse all need medical assessment before anything else. EMSella is not appropriate if you are pregnant, have a pacemaker or metal implants in the pelvic area, or have a coil fitted, and that is checked before you book.
Come in comfortable clothing with no metal in the pocket area, and empty your bladder beforehand. Tell us about any implanted device, a coil, pregnancy or recent surgery. You will not need to undress at any point.
You sit on the chair fully clothed for twenty eight minutes. The sensation is unusual rather than unpleasant, a tingling and a strong contracting feeling that builds as we adjust the intensity. Most people read or use their phone.
Nothing at all. Drive yourself home and carry on with your day. Some people feel mild muscle fatigue in the pelvic area, similar to after exercise. Most notice a change partway through the course, with the full benefit a few weeks after it ends.
Pelvic floor exercises genuinely work, and they are the first thing anyone should try. The problem is that most people do them wrongly or give up too soon.
Done properly, that means squeezing as though stopping the flow of urine and lifting inward, holding for a count of five, releasing fully, and repeating ten times, three times a day, for at least three months before judging it. Not squeezing your buttocks or holding your breath. The NHS Squeezy app is genuinely useful for remembering. Alongside that, reducing caffeine and alcohol helps urge symptoms considerably, staying well hydrated matters more than people think, since concentrated urine irritates the bladder, and treating constipation removes a constant downward pressure.
Where this stops is when the exercises are being done correctly and consistently and symptoms remain, which is very common after childbirth or where tissue has thinned with menopause. It is difficult to contract a muscle you can barely feel, and that is precisely the gap EMSella fills: it contracts it for you, thousands of times, at an intensity you could not produce voluntarily.
Please see your GP rather than us if there is blood in your urine, pain, recurrent infections or a sudden change in your symptoms.
A single session is £180 and a course of six is £920. The course is what produces a meaningful result; a single session is really for seeing what the treatment is like.
No. You stay fully clothed throughout and simply sit on the chair. This is the question we are asked most, and the answer is the reason many people choose it over the alternatives.
Unusual rather than uncomfortable. A tingling sensation with strong contractions in the pelvic floor, building as the intensity is increased. Most people read or use their phone throughout.
Six, taken as two a week over three weeks. Most people notice a difference partway through, with the full effect a few weeks after finishing. A top up once or twice a year maintains it.
For stress incontinence caused by a weakened pelvic floor, it works well for most people. Urge incontinence often improves too but can involve the bladder muscle as well, which may need your GP. We will tell you which pattern you have.
Yes, and it is one of the most common reasons people come. We would wait until at least three months after delivery, and longer after a caesarean or any complication. Not during pregnancy.
Yes. Men experience incontinence too, particularly after prostate surgery, and the treatment is identical. It is considerably less discussed, which is precisely why it goes untreated.
It is not suitable during pregnancy, or if you have a pacemaker, defibrillator, metal implants in the pelvic area or a copper coil. We check all of that before you book rather than on the day.
Yes, and they work better afterwards because you can feel the muscle properly. Think of the course as getting the muscle back to a point where your own exercises become effective.
Typically around a year, sometimes longer with regular exercises. A single top up session once or twice a year maintains it for most people rather than repeating the whole course.
Please do if you have blood in your urine, pain, recurrent urine infections, a prolapse, or symptoms that came on suddenly. Those need a medical assessment before any treatment here.
Entirely. It is a conversation in a private room and nothing about it requires an examination. Many people have never discussed this with anyone, and there is no rush and no judgement.
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