- Stress incontinence. Some experts believe that Kegel exercises should be the primary treatment for stress incontinence.
- Urge incontinence. They can also be helpful for urge incontinence in cases that are not caused by nerve damage. In one study, 85% of women reported satisfaction with this program.
The general approach for learning and practicing Kegel exercises is as follows:
- Since the muscles are sometimes difficult to isolate, the best method is to first learn while urinating. The patient begins to urinate and then contracts the muscle in the pelvic area with intention of slowing or stopping the flow of urine. Women should contract the vaginal muscles as well. They can detect this by inserting a finger inside the vagina. When the vaginal walls tighten, the pelvic muscles are being correctly contracted.
- An alternate approach is to isolate the muscles used in Kegel contractions by sensing then squeezing and lifting the muscles in the rectum that are used in passing gas. (Again, women should contract the vaginal muscles as well.)
- Patients should place their hands on their abdomen, thighs, and buttocks to make sure there is no movement in these areas while exercising.
- In order to achieve success, some experts recommend performing two exercises that have different timing for the hold and release of the contraction. Both should be done regularly.
- The first method is used for strengthening the pelvic floor muscles. The patient slowly contracts and lifts the muscles and holds for5 seconds, then releases them. There is a rest of 10 seconds between contractions.
- The second method is simply a quick contraction and release. The object of this exercise is to learn to shut off the urine flow rapidly.
- In general, patients should perform five to 15 contractions, three to five times daily.
Some notes of caution:
- Once learned, Kegel exercises should not be performed while urinating more than about twice a month, since this practice may eventually weaken the muscles.
- In women, incorrect or overly vigorous exercises may cause vaginal muscles to tighten excessively, resulting in pain during sexual intercourse.
- Over-exercise can also tire muscles and cause more leakage.
- Incontinence will return to its original severity if these exercises are discontinued, so commitment to the program must be high and possibly life-long.
- It may be several months before the patient sees significant improvement.
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