Pelvic Floor Exercises
Pelvic floor exercises, also called Kegel exercises or pelvic floor muscle (PFM) training, are often used in the treatment of stress incontinence. These exercises are designed to strengthen and tighten pelvic floor muscles.
The pelvic floor muscles can become weakened due to pregnancy and childbirth or due to aging and being overweight. When the pelvic floor muscles weaken the pelvic organs descend and bulge into your vagina — a condition known as pelvic organ prolapse. The effects of pelvic organ prolapse range from uncomfortable pelvic pressure to leakage of urine. Kegel exercises can help delay or even prevent pelvic organ prolapse and the related symptoms.
- When PFM training is initially successful, there is a 66% chance that the favourable results will persist for at least 10 years.
- Bladder prolapse
- Vaginal laxity
- Radical prostatectomy in elderly patients with prostate cancer. 
Use the Correct Muscles:
- The goal is to squeeze the muscles around your vagina and anus. These are the muscles you use to prevent gas from passing, stop the flow of urine and the muscles that contract during orgasm.
Contract the Correct Muscles:
- Think about trying to pull the muscles up and in (if your pelvic floor is weak, you will only faintly feel this contraction). You'll know you're doing these exercises correctly if you feel the muscles tightening but don't have movement in your abs or buttocks. Isolate your pelvic floor so if somebody looked at you while you were doing the exercise, they wouldn't think you were moving at all.
- Don't . . .
- hold your breath (you should be able to talk easily at the same time)
- tighten your abdomen, thigh or buttock muscles
- squeeze your legs together
Types of Contractions: The type of contraction that you use will determine the effect that you experience.
- Slow contractions help to increase the strength of your pelvic floor. They help your muscles to hold back the urine.
- Lift your pelvic floor muscles to a count of ten.
- Hold the muscles tight for 10 seconds. You may find at first that you can only hold the contraction for one or two seconds, so concentrate on lifting your muscles and holding the contraction for as long as you can. Gradually increase the time until you reach 10 seconds.
- Relax your muscles and rest for 10 seconds.
- Repeat the contractions up to 10 times.
- Fast contractions help your pelvic floor to cope with pressure, for example when you sneeze, cough or laugh. This works the muscles that quickly shut off the flow of urine.
- Lift your pelvic floor muscles quickly.
- Hold the contraction for one second.
- Relax the muscles and rest for one second.
- Repeat the contractions 10 times.
Frequency of Exercises
- Try to do one set of slow contractions and one set of fast contractions six times a day when treating stress incontinence.
- Doing a fast contraction just before you cough, sneeze or laugh can prove very beneficial. Doing a fast contraction just before you get out of a chair can also be beneficial as the movement of getting up puts pressure on your bladder and pelvic floor.
- To strengthen the pelvic floor muscles in the absence of symptoms, do slow contractions 10 times, 3 times per day, three times per week.
To know if you are doing them correctly
- Put a couple of fingers into your vagina. You should feel a gentle squeeze when doing the exercise.
- Put your hands on your abdomen and buttocks to make sure you can’t feel your belly, thighs, or buttocks moving.
- You may initially practice Kegels by stopping the flow of urine while going to the bathroom, but it is not advised to do this frequently as stopping the flow of urine can cause backflow which may cause a urinary tract infection and can disrupt your pelvic muscle coordination.
- Cammu H, Van Nylen M, Amy JJ (Apr 2000) A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence. BJU Int;85(6):655-8.
- Park SW, Kim TN, Nam JK, Ha HK, Shin DG, Lee W, Kim MS, Chung MK (Aug 2012) Recovery of overall exercise ability, quality of life, and continence after 12-week combined exercise intervention in elderly patients who underwent radical prostatectomy: a randomized controlled study. Urology;80(2):299-306.