Kegel's Exercises

These exercises, called Kegel's after the doctor who invented them, are excellent for a variety of reasons. They are recommended for women after childbirth to tighten and improve muscle tone in the vagina. They are used by women to increase sexual feelings. They are very useful to help control urine in women who are at times incontinent and to prevent future incontinence (loss of urine).

First, to identify the pubococcygeus (PCG) muscle, try stopping your urine flow. Do that a few times. You should then be able to feel the muscle contracting. Insert one finger into the vagina and feel how to contract it independently of your stomach muscles, you are ready to begin the exercises. There are two different sets of exercises for the different fibers around the urethra:

  • First rapidly squeeze and release the muscle without losing coordination until tired. This is one set. Do 3 sets daily trying to increase the number you can do in one set.
  • Second, hold a contraction for at least 6 seconds with 10 seconds rest in between. Do at least 10 times. This is one set. Do 3 sets daily and try to increase the number you can do in one set.
  • Also, practice "fake" coughs, performed while tightening the pelvic floor. This is how all coughing should be done in the future to cause less strain on your bladder.

All of this may seem consuming, but it takes only a few minutes a day and can be done anywhere; at home, at your office desk, in your car. Persevere as it takes two or three weeks for any noticeable changes to occur and up to three months for the maximum effect. It is worth it on several counts - you will have good muscle tone, you will feel increased sensitivity in your genital area and you will notice significant improvement in your urinary incontinence (if this is a problem).

There are many lifestyle factors that can be changed to improve bladder control. Chronic coughing greatly aggravates incontinence. If you smoke, you must quit or your leakage will worsen due to the excessive coughing. You should avoid wearing girdles, lifting heavy objects and excessive "up and down" motions such as hi impact aerobics as these increase intro-abdominal pressure. Jogging can exacerbate some patient's incontinence. Urinary tract infections can also aggravate leakage so your physician will want to check your urine for infection.

VAGINAL WEIGHTS

There are small weights resembling a tampon that can be inserted into the vagina and worn for 20-30 minute intervals daily to help strengthen these same muscles. These are excellent for busy women who do not take the time to do their Kegel exercises. The weights can be worn while you are doing housework or even at work. You begin with the lightest weight and when this becomes easy to hold in the vagina for 30 minutes, advance to the next weight. Ask your physician to show these to you. If interested, we can give you information on how you can order these.