"Following the birth of her third child in  Trisha Smick began to experience embarrassing bladdercontrol issues. A personal trainer and national fitness competitor Smick  of Medford found that a simple cough or sneeze or lifting a weight in a certain way spurred a small leak of urine. She performed Kegel exercises to strengthen her pelvic floor which can be weakened during childbirth. She consulted a urologist. But she couldnt solve the problem. So this spring she turned to Beverly Mikes a Cherry Hill obgyn who offers a controversial treatment called the OShot to treat stress incontinence and urinary frequency. Urinary incontinence is a common condition in women. Approximately  percent of young women around half of middleaged and postmenopausal women and threefourths of older women experience some involuntary urine loss according to the American Congress of Obstetricians and Gynecologists. The group estimates that . billion a year is spent on treatments which run the gamut from behavior modification to surgery. Then theres the OShot meant for the  percent of women who have stress incontinence  leakage associated with a strain such as sneezing or lifting. The OShot is an injection of plateletrich plasma spun from the patients own blood. If that concept sounds familiar little wonder It was developed by the same man who brought us the vampire facelift that went viral when professional celebrity Kim Kardashian started touting it. The vampire breast lift is alleged to work similarly. Neither is approved by the Food and Drug Administration. The Louisiana doctor who developed all these ideas Charles Runels also came up with the OShot an injection of plateletrich plasma into the clitoris for the purpose of enhancing sexual pleasure. Theres no peerreviewed scientific evidence that any of this works. But people who used the OShot started claiming that it helped with incontinence. The evidence is anecdotal but that doesnt appear to stop women desperate to solve an embarrassing problem. And there are doctors such as Mikes eager to help them  she is one of numerous doctors in the Philadelphia area and across the nation Runels lists on his oshot.info website. The obgyn left private practice after  years to join the Hughes Center for Aesthetic Surgery in Cherry Hill in part to treat stress incontinence with plateletrich plasma. After all she notes the therapy has been used for  years for painful joints arthritis sports injuries and wound healing. The plasma contains our bodies own growth factors that stimulate cells to help increase collagen elastin as well as more vasculature and nerves Mikes said. Therefore by stimulating new tissues and regenerating tissue it can help treat stress incontinence. Frustration over her inability to help women with stress incontinence with conventional therapy partly drove her to change her career she said. You can have major surgery or you can kind of live with it. Stress incontinence is not typically very responsive to medication. It was very exciting for me to offer women treatment that they otherwise would not be able to get in a typical office. As for the lack of peerreviewed journal articles on the OShot but thats true with anything new Mikes said. If we never embarked on new things we wouldnt have the treatment we have today. During Smicks procedure Mikes drew blood from her arm then used a special centrifuge to separate red blood cells from plasma resulting in  ccs of the yellow serum of plateletrich plasma or as Mikes calls it liquid gold. After topical numbing and injection with a local anesthetic four ccs of this serum was injected into Smicks interior vaginal wall and  cc directly into the clitoris. I have to admit that the idea of getting injections in the vagina and clitoris was unnerving says Smick. But in the end. it was pressure but not pain. According to Mikes it takes a while to notice improvement. After three months there is a  percent success rate and after three months a second shot can be given if the person has not experienced success she says noting that those who receive a second treatment experience an  percent success rate. Her figures come from a data bank maintained by Runels. Mikes has treated about  patients since January. A single treatment is about  and is not covered by insurance. Depending on the patients responsiveness to the OShot Runels recommends a yearly injection for maintenance sake Mikes said. Without strong evidence for its efficacy the American Congress of Obstetricians and Gynecologists does not include the treatment in its Practice Bulletin for Urinary Incontinence in Women. L. Elaine Waetjen professor of obstetrics and gynecology at the University of California Davis Medical Center who has spent more than  years treating women for this problem said that there is no scientific evidence that the OShot works for incontinence and there is also no clear biological mechanism for why it should treat this condition. She noted in an email that although it is advertised as a treatment for many different genitourinary problems  there is no scientific evidence that it works for any of these conditions. Though some people may be swayed by someone elses positive experience  they need to be cautious because individual testimony does not control for the placebo effect of treatment she said. Waetjen added that there are many treatments for urinary incontinence that do have good scientific evidence. They range from behavioral modification e.g. reducing fluid intake and losing weight as obesity can be connected with incontinence to physical therapy medication and surgery. A urogynecologist can offer women these different treatment options she wrote. Although Smick acknowledges that it might be a coincidence a few weeks after the procedure she said that she did feel some extra sexual sensation and more bladder control. Normally I cross my legs in preparation when I sneeze Smick said but lately I havent felt the need to do that. By midJune she said that her bladder control was about  percent improved. While Smick once experienced bladder leakage while bending  over to lift weights or sneezing now its limited to extreme situations such as when I have a bad coughing fit. It doesnt happen day to day anymore she said. I think that there are a lot of women who experience this problem but not many people feel comfortable talking about it she added. Im just very open and if I could be a spokesperson for this I would even if it puts me out there a little bit."