Information

Kegel exercises are recommended for:

• Women with urinary stress incontinence
• Some men who have urinary incontinence after prostate surgery
• People who have fecal incontinence

Kegel exercises can help strengthen the muscles under the uterus, bladder, and bowel (large intestine). They can help both men and women who have problems with urine leakage or bowel control.

A Kegel exercise is like pretending that you have to urinate, and then holding it. You relax and tighten the muscles that control urine flow. It's important to find the right muscles to tighten.

The next time you have to urinate, start to go and then stop. Feel the muscles in your vagina, bladder, or anus get tight and move up. These are the pelvic floor muscles. If you feel them tighten, you've done the exercise right.

If you are still not sure whether you are tightening the right muscles. keep in mind that all of the muscles of the pelvic floor relax and contract at the same time. Because these muscles control the bladder, rectum, and vagina, the following tips may help:

• Women: Insert a finger into your vagina. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.
• Men: Insert a finger into your rectum. Tighten the muscles as if you are holding in your urine, then let go. You should feel the muscles tighten and move up and down.

It is very important that you keep the following muscles relaxed while doing Kegel exercises:

• Abdominal
• Buttocks
• Thigh

A woman can also strengthen these muscles by using a vaginal cone, which is a weighted device that is inserted into the vagina. Then you try to contract the pelvic floor muscles to hold the device in place.

If you are unsure whether you are doing the Kegel correctly, you can use biofeedback and electrical stimulation to help find the correct muscle group to work.

• Biofeedback is a method of positive reinforcement. Electrodes are placed on the abdomen and along the anal area. Some therapists place a sensor in the vagina in women or anus in men to monitor the contraction of pelvic floor muscles.
• A monitor will display a graph showing which muscles are contracting and which are at rest. The therapist can help find the right muscles for performing Kegel exercises.

PERFORMING PELVIC FLOOR EXERCISES:

1. Begin by emptying your bladder.

2. Tighten the pelvic floor muscles and hold for a count of 10.

3. Relax the muscle completely for a count of 10.

4. Do 10 exercises, 3 times a day (morning, afternoon, and night).

You can do these exercises at any time and any place. Most people prefer to do the exercises while lying down or sitting in a chair. After 4 - 6 weeks, most people notice some improvement. It may take as long as 3 months to see a major change.

After a couple of weeks, you can also try doing a single pelvic floor contraction at times when you are likely to leak (for example, while getting out of a chair).

A word of caution: Some people feel that they can speed up the progress by increasing the number of repetitions and the frequency of exercises. However, overexercising can instead cause muscle fatigue and increase urine leakage.

If you feel any discomfort in your abdomen or back while doing these exercises, you are probably doing them wrong. Some people hold their breath or tighten their chest while trying to contract the pelvic floor muscles. Relax and concentrate on contracting just the pelvic floor muscles.

When done the right way, Kegel exercises have been shown to be very effective in improving urinary continence.

Alternative Names

Pelvic muscle strengthening exercises; Pelvic floor exercises

References

Holroyd-Leduc JM, Tannenbaum C, Thorpe KE, Straus SE. What type of urinary incontinence does this woman have? JAMA. 2008;299:1446-1456.

Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008;358:1029-1036.

Update Date: 4/17/2012

Reviewed by: Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.