Pelvic floor (Kegel) exercises for urinary incontinence in women

	Treatment Overview
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Exercises that strengthen the pelvic muscles involved in urination are used to treat both stress incontinence and urge incontinence. Pelvic floor (Kegel) exercises are done as follows:

• Identify the pelvic floor muscles involved by purposely stopping the flow of urine in midstream and then allowing the urine to flow again, or by trying to prevent passing gas. These are the muscles that squeeze the urethra and anus.
• Remembering what it felt like to control these muscles during urination or in trying to prevent passing gas, try to contract them without urinating. If your stomach muscles tighten, your pelvic muscles are not being exercised correctly.
• Tighten your pelvic muscles for 3 seconds and then relax them for 3 seconds.
• Repeat the Kegel exercises 10 to 15 times each session, and do at least 3 sessions a day.

Kegel exercises can be performed while traveling, at work, or at random moments during the day. No one will be aware that you are doing the exercises, so you can repeat them frequently.

Kegel exercises are often combined with biofeedback techniques to teach the proper exercise methods and to maintain exercise effectiveness. Biofeedback allows you to see, feel, or hear when an exercise is being performed correctly. This can be done by placing a finger in your vagina or anus to feel it contract when the pelvic muscles are exercised.

More elaborate devices can also be used that measure the pressure of the bladder and abdominal muscles or provide a measurement of the pressure within the vagina.

Another exercise technique involves using a weighted cone that is inserted into the vagina. You must contract the pelvic muscles to prevent the cone from dropping out of the vagina. A set of cones identical in size and shape but of increasing weight are provided. As treatment progresses, heavier cones are used that require stronger contractions to keep them in place.

Kegel exercises can be done throughout your life.

Kegel exercises may be used to treat stress incontinence or urge incontinence.

Kegel exercises improve or cure stress urinary incontinence in nearly 70% of those who use them.¹

Kegel exercises do not pose any risks to a woman's health.

Kegel exercises require a high level of motivation and frequent repetition to be successful.

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Citations

1. Lentz GM (2007). Physiology of micturition, diagnosis of voiding dysfunction, and incontinence: Surgical and nonsurgical treatment. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 537–568. Philadelphia: Mosby Elsevier.