Skip to main content

Poise Impressa

Poise Impressa was a single-use, tampon-like vaginal insert sold over the counter for female stress urinary incontinence (SUI).[1] Its instructions describe an insert that supports the urethra to help prevent leakage, a sizing kit (sizes 1–3), and self-insertion at home with an applicator.[7] Poise states that Impressa products have been discontinued; the device specifications and trial results below describe a discontinued product.[6]

For the umbrella article on intravaginal continence devices and the broader pessary class, see Continence Pessary. For the female SUI ladder, see the Female Stress Incontinence Database. For women with SUI, the EAU guideline recommends supervised intensive pelvic floor muscle training for at least three months as first-line therapy; see Pelvic Floor PT.[8]

How It Works​

Impressa was a single-use, tampon-like vaginal insert sold over the counter for SUI.[1] Poise's instructions describe applicator insertion and support to the urethra that helps prevent leakage while still allowing normal voiding.[7]

FeatureDetail
ClassDisposable intravaginal continence device (DICD)
Sizes1, 2, 3 — sizing kit available[7]
Wear timeUp to 12 hours total in a 24-hour period (Poise instructions)[7]
UseSingle use — discard after wear
DistributionOver the counter; no prescription required[1][2]
FittingNo in-office examination required[1]

Indications​

  • Female stress urinary incontinence. Leakage on cough, sneeze, exertion.[1][2]
  • Situational SUI. Especially exercise- or activity-related leakage where on-demand control is desired.[2]
  • Patients who prefer a non-pharmacologic, noninvasive option, or who wish to avoid or delay surgery.[5]
  • Patients unlikely to adhere to behavioral or pelvic-floor-muscle-training programs.[5]

It was intended for SUI, not urgency or overflow leakage; Poise specifically excluded mixed urinary incontinence.[6]

Contraindications and Precautions​

Poise instructions say not to use Impressa under age 21; during pregnancy or possible pregnancy; within three months of childbirth or vaginal surgery; after unexpected vaginal bleeding within six months; with painful urination or vaginal infection symptoms; or with diagnosed severe vaginal atrophy. Do not wear it during menses or intercourse. Remove it and contact a doctor immediately for fever of 102°F with any listed systemic symptom because toxic shock syndrome is possible.[7] Poise also advised removal and clinician consultation for blood spots, vaginal soreness or discomfort, infection symptoms, or increased leakage.[6] Poise also advised asking a doctor before use when intercourse or tampon insertion is painful, or a tampon-like device is difficult to retain; discomfort or no reduction in leakage after 14 days warrants evaluation.[6]

  • Pregnancy
  • Active urinary tract infection
  • Postmenopausal bleeding (un-evaluated)
  • Neurogenic bladder
  • Urinary retention
  • Prolapse
  • Prior SUI surgery or prior treatment with a continence pessary or device

Clinical Evidence​

The Impressa-specific evidence base is limited; the contemporary expert reviews position it within the broader literature on intravaginal continence devices.

Nekkanti 2022 RCT — Impressa vs continence pessary​

A multicenter randomized trial compared Impressa (a disposable intravaginal continence device) with a fitted continence pessary at 4 weeks. Treatment success was based on the Patient Global Impression of Improvement. Fifty women were enrolled, 35 completed a fitting, and 22 completed 4-week follow-up:[4]

EndpointImpressaContinence pessaryp
Treatment success at 4 weeks75% (9/12)80% (8/10)1.0
Improvement on questionnaire measuresImproved on all questionnairesImproved, except lower sexual function scores at 4 weeks—
Serious adverse events00—
Use of additional therapies over 6 moHigherLower—

The trial was stopped early for slow enrollment (50 of a planned 138 participants) and was underpowered. Only 34% of enrolled women completed 6-month follow-up.[4]

Expert reviews​

  • JAMA review (Lukacz 2017). OTC vaginal-insert devices such as Impressa "may provide an alternative noninvasive treatment, although comparative data are lacking."[2]
  • NEJM review (Wu 2021). Impressa is described as a commercially available option, but "additional comparative effectiveness studies are needed."[1]
  • Cochrane overview (Todhunter-Brown 2022). Mechanical devices including disposable intravaginal devices are within scope of conservative SUI therapy; certainty of benefit is modest.[3]

Place in the SUI Treatment Algorithm​

TierOption
First-linePelvic floor muscle training (about half of women with stress-predominant UI are satisfied 1 year after starting) ± behavioral / lifestyle (weight loss, fluid / caffeine modulation)[2][5]
Other nonsurgical optionsFitted continence pessary or Uresta; Poise Impressa was a historical OTC option that has been discontinued.[1][5][6]
Procedural optionsUrethral bulking, midurethral sling, autologous fascial PVS, or Burch colposuspension, selected through shared decision-making; bulking is less effective than the listed operations and repeat injections may be required.[1][8][9]

Before discontinuation, Impressa was a nonsurgical vaginal-support option alongside fitted continence pessaries and PFMT. The 2024 CUA guideline recommends offering pessaries and other vaginal devices to suitable women with SUI .[6][11] ACOG positions pessary-class therapy as appropriate for patients who wish to avoid surgery, are not likely to adhere to PFMT, or want immediate situational symptom control.[5]

Comparison with Other Intravaginal Continence Devices​

DeviceReusableProvider fit neededOTCWear time
Poise Impressa (discontinued)No (single use)No — patient self-fitsHistorically OTC; no longer marketed[6]Up to 12 h total in 24 h[7]
UrestaYes (up to 12 mo)[12]Patient self-selects and fitsYes — OTCDaily use; remove at bedtime[10]
Fitted continence pessary (ring/dish with knob)YesYes — provider fittingNoLong-term with periodic checks

When sold, Impressa required no prescription or in-office examination; the manufacturer has since discontinued it.[1][6]

Limitations​

  • No large well-powered RCT specifically against sham or no treatment; the available comparative trial was underpowered.[4]
  • Symptomatic relief. The device manages leakage only while in place.

Key Principles​

  • Before discontinuation, Impressa was a single-use OTC vaginal insert for SUI.[1][6] Poise's instructions described a sizes 1–3 sizing kit and a limit of 12 hours' wear in 24 hours.[7]
  • Best suited for patients with situational or activity-related SUI, those preferring noninvasive options, or those unlikely to adhere to PFMT.[2][5]
  • The Nekkanti 2022 RCT found no significant difference in 4-week treatment success versus a fitted continence pessary (75% versus 80%, p = 1.0) but was underpowered (n = 50 of planned 138; 22 completed 4-week follow-up).[4]
  • Impressa is a nonsurgical vaginal insert; fitted continence pessaries and PFMT are other nonsurgical options, while urethral bulking and surgery are procedural options.[1][5][9] EAU recommends supervised intensive PFMT for at least three months as first-line SUI therapy .[8]
  • Historical OTC access. Impressa was sold without a prescription before it was discontinued.[1][2][6]
  • Comparative effectiveness data remain limited; JAMA and NEJM reviews both call for larger trials.[1][2]
  • Poise excluded urge and mixed urinary incontinence; Impressa was not indicated for overflow incontinence.[6] The Nekkanti trial excluded pregnancy, active UTI, neurogenic bladder, urinary retention and prolapse.[4]

References​

1. Wu JM. Stress incontinence in women. N Engl J Med. 2021;384(25):2428-2436. doi:10.1056/NEJMcp1914037.

2. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary incontinence in women: a review. JAMA. 2017;318(16):1592-1604. doi:10.1001/jama.2017.12137.

3. Todhunter-Brown A, Hazelton C, Campbell P, et al. Conservative interventions for treating urinary incontinence in women: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022;9:CD012337. doi:10.1002/14651858.CD012337.pub2.

4. Nekkanti S, Wu JM, Hundley AF, et al. A randomized trial comparing continence pessary to continence device (Poise Impressa®) for stress incontinence. Int Urogynecol J. 2022;33(4):861-868. doi:10.1007/s00192-021-04967-9.

5. ACOG Practice Bulletin No. 155: urinary incontinence in women. Obstet Gynecol. 2015;126(5):e66-e81. doi:10.1097/AOG.0000000000001148.

6. Poise. Impressa Frequently Asked Questions: Impressa Availability. Manufacturer FAQ.

7. Poise. Poise Impressa Bladder Supports: Instructions for Use. Manufacturer instructions.

8. European Association of Urology. Guidelines on Non-neurogenic Female LUTS, disease management §4.2.4.a.3.g (Limited Update March 2026). Guideline.

9. Kobashi KC, Vasavada S, Bloschichak A, et al. "Updates to Surgical Treatment of Female Stress Urinary Incontinence (SUI): AUA/SUFU Guideline (2023)." J Urol. 2023;209(6):1091-1098. doi:10.1097/JU.0000000000003435. Full AUA/SUFU guideline.

10. U.S. Food and Drug Administration. "510(k) Summary K233548: Uresta Bladder Support." 2024. FDA 510(k) summary

11. Carlson K, Andrews M, Bascom A, et al. "2024 Canadian Urological Association guideline: Female stress urinary incontinence." Can Urol Assoc J. 2024;18(4):83-102. doi:10.5489/cuaj.8751

12. Uresta. "Bladder Support Starter Kit." Manufacturer product page (accessed October 2026).