Tips & Tricks for Usage

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Life. Not leaks. BLADDER SUPPORT FOR WOMEN Tips & Tricks for Usage Based on feedback from users and clinicians, here are some questions and answers that might help with using your uresta bladder support for the effective treatment of stress urinary incontinence. How does uresta work? Does urine come gushing out when the device is removed? No, urine will not come gushing when uresta is removed. uresta is inserted into the vagina, and is shaped so that the widest part of the device provides support to the urethra to reduce or completely eliminate unwanted leaks. I just received my uresta starter kit and I am worried about trying it. It looks big and I worry that it will be uncomfortable. What should I expect? Could you provide some tips on inserting the device? Some women might find it intimidating to first try their uresta device; however, after some experimenting with different sizes and upon determining the correct size and position for them, uresta can make a significant difference. Using a water-based lubricant will make insertion easier. Select the smallest-sized bladder support (size 3). Prior to insertion, wash hands with soap and water and rinse thoroughly. Some women may find it easier to insert uresta with one leg supported higher than the other, such as having a foot on the toilet or a stool. Page 1 of 5

To insert, follow these steps: 1. Holding the handle, place lubricant on the tip of the uresta device; 2. Using the other hand, separate the labia or the opening to the vagina; 3. Gently push the uresta device into the vagina aiming towards the spine. As the device enters the vagina the tapered end will help to open the vagina. You will feel some pressure and resistance at the opening and as you continue to push it in and below the pubic bone, at which point the pressure will go away and the resistance will stop. With your finger touching the end of the handle, push the support inside to approximately 2 cm (¾ inch) or until the first knuckle of your finger is at or just inside the opening of the vagina. You should not feel any pain when the uresta bladder support is properly fitted. Once inserted, move around to see if the uresta dislodges or slides down; if it does, you might want to try the next size up. If you find it uncomfortable, consider repositioning it or try the next size down. It might take some time to find the right fit and position, and might take some time to get used to the new sensation of the uresta, but you should not feel any pain or discomfort during its use. If you think you require a smaller size or larger size than those included in the kit, contact your retailer. The use of a water-based lubricant can be very helpful for insertion, as there might be some discomfort and pressure when first inserting the uresta, but there should not be pain. If there is pain, there could be other conditions that need to be examined and treated before using uresta. Please consult your doctor or pelvic health physiotherapist, or other clinical practitioner for advice and guidance. How do I know if it is properly fitted? How far up should I push the uresta into my vagina? There are several good indicators of a properly sized and positioned uresta : There should be very little or no sensation; The handle is inserted within the vagina to the approximate depth of 2cm (¾ inch) from the opening of the vagina, which generally can be checked by inserting one finger up to the first knuckle and being able to touch the end of the uresta handle; When you cough, sneeze, or move around, bladder leakage is stopped or significantly reduced; You can urinate or have a bowel movement with your uresta support in place. Page 2 of 5

When properly fitted, there should be very little or no sensation of the uresta device. Some women describe a sensation as to be aware there is something inside, which may require time to get used to the new sensation, but it should not be painful. If there is pain, there could be other conditions that need to be examined and treated before using uresta. Please consult your doctor or pelvic health physiotherapist, or other clinical practitioner for advice and guidance. I had difficulty removing my uresta once inserted. Can you provide some tips for easier removal? Prior to removing, wash hands with soap and water and rinse thoroughly. The vaginal muscles naturally help hold the uresta in place. To easily remove the uresta, it helps to relax the pelvic floor, which can be done with a few deep cleansing breaths and releasing the pelvic muscles in the same manner as you relax your muscles to urinate. Separate the labia of the vagina with the finger of one hand and insert the index finger of your other hand to locate the handle of the uresta device. Grasp with your thumb and index finger and pull the device directly down and out. Some women find that removal can be aided with a small twist of the uresta handle while gently pulling the unit, thereby breaking the seal and allowing the uresta to be removed more easily. If you are having difficulty reaching the handle, bear down as if you are trying to have a bowel movement, as this will help move the device down so that you may more easily grasp the handle and remove. I use uresta regularly and it generally works well, but I notice I leak more when I exercise or when I cough when I am sick. Some women find they use two sizes depending on their activities and state of health. Women report using one size throughout the day, but move up a size when exercising. Others will use a larger size when they know they might be coughing, sneezing, or even laughing more than usual. What if I forget to take my uresta out at night? Not a problem. uresta can safely be worn for up to 24 hours without concern. Can I insert it too far? If you follow the insertion directions, positioning your uresta just past the opening to the vagina, then you do not have to worry about inserting it too far. Page 3 of 5

When inserting, once the device passes beyond the entrance to the vagina and under the pubic bone, so there is no further pressure or resistance, the device will be approximately 2 cm (¾ inch) from the opening of the vagina. You should be able to feel the end of the uresta handle by inserting one finger up to the first knuckle. If, when properly inserted, the device does not work, consider moving up a size. I tried using uresta for the first time and I found it painful to insert and remove, but it did reduce my bladder leakage. Insertion and removal should not be painful. If uresta is working for you but is uncomfortable inserting and removing, consider trying a smaller size. If you do experience pain, stop using the device until you have consulted a physician, pelvic health physiotherapist, or other clinical practitioner about the appropriateness of using a pessary (the clinical term for pelvic floor support devices) and to determine if there are other conditions contributing to the pain that might require treatment. I am post-menopausal and have vaginal dryness and/or atrophy. Can I still use uresta? If you are unsure whether uresta might be appropriate for you, given pre-existing health concerns, you should consult your doctor, pelvic health physiotherapist, or other clinical practitioner. Women with vaginal dryness and/or atrophy do use uresta to successfully help them with their stress urinary incontinence, often in conjunction with appropriate treatment for the dryness. I have a mild case of prolapse. Will uresta help me? uresta is not indicated for the treatment of prolapse. If you are unsure whether uresta might be appropriate for you, given pre-existing health concerns, such as prolapse, you should consult your doctor, pelvic health physiotherapist, or other clinical practitioner. Is it normal to experience some bleeding when I first start using uresta? No, it is not normal, but some spotting can occur if a woman has certain, pre-existing health conditions that might be irritated by the use of uresta. If you have any pre-existing health concerns that might be irritated by the use of any intravaginal device, you should consult your doctor, pelvic health physiotherapist, or other clinical practitioner before using a device. Page 4 of 5

I started using uresta and it did help reduce my leaking but not completely. Is there anything that I can do to improve my results? uresta has been clinically proven to significantly reduce or eliminate bladder leakage caused by stress urinary incontinence in 80% of women tested. If you still leak with your uresta device properly fitted, consider trying one size larger to see if that helps eliminate leaks. If you still leak, you might consider seeing your doctor or a pelvic health physiotherapist to determine if you might have other conditions contributing to the problem or to recommend additional treatments for your stress urinary incontinence, such as pelvic floor exercises. The use of pads with uresta is also an option in cases where uresta reduces but does not eliminate all leaks. What should I do if I accidentally insert the uresta too far into the vaginal canal and I cannot reach it to remove it? If you are having difficulty reaching the handle, take a few deep breaths to help relax and bear down as if you are trying to have a bowel movement. This will help move the device down so that you may more easily grasp the handle and remove. Also, consider trying different positions such as sitting on the toilet, lying down on a bed, or propping on leg up on a stool for better access to the vaginal opening. Should you encounter further difficulty in removing the device, seek medical advice and assistance if needed. I have had vaginal surgery in the past but still leak. Can I use uresta? uresta should not be used if you have had recent vaginal surgery. If you have any questions about the appropriateness of using uresta, consult your doctor, pelvic health physiotherapist, or other clinical practitioner prior to using the device. How should I clean my uresta? Should it be sterilized, at least on occasion? Use warm water and a mild, non-scented soap to wash your uresta, rinsing thoroughly with water after washing. Dry with a clean cloth or towel, or simply allow it to air dry. Always wash it before putting it back into your vagina. uresta never has to be sterilized or cleaned with harsh chemicals to be safe for use. It is recommended that uresta be replaced annually. For more information, visit uresta.com Copyright 2018 uresta - Bladder Support for Women Manufactured by Southmedic Inc. Marketed by Resilia Medical Solutions Made in Canada Page 5 of 5