Conservative Treatment

Kegel’s Exercises

Arnold Kegel in 1950 recommended performing as many as 300 to 400 pelvic floor muscle contractions daily, but gave little information about the intensity of each contraction. Instructor-conducted exercises are very important in establishing the correct action of the pelvic floor muscle and maintaining motivation to continue with the exercise program.

In addition to the muscle group being exercised, specificity concerns the type of training and the exercise program should allow relaxation between contractions. Since continued vigorous exercise can lead to muscle soreness and fatigue.

Traditionally, pelvic floor muscle exercises are practiced in isolation, without activity of the abdominal or hip muscles. In the beginning, it is very important to check frequently by looking in the mirror and placing a hand on the abdomen and buttocks to ensure that the belly, thigh, or buttock muscles do not move. We may imagine that we have a tampon in the vagina that is falling out and we must tighten our muscle in order to hold it in.

If there is movement, continue to experiment until to isolate just the muscles of the pelvic floor. If it is difficult to contract theses muscles, it is important to use other positions, such as lateral side-lying. In palpating the perineal region through clothes (tailbone or coccyx), one should feel tissues move away from finger. In the supine with back on the floor, place two fingers inside patient’s vagina could help, like to sit on the toilet, place one finger in the vagina and contract that muscle around the finger: if accepted !

The gradation, or progression of exercises is also considered important, because the function of the pelvic floor at the beginning of a training program may vary considerably from one person to another.

Exercises may be progressed by increasing the duration of the contraction or the number of repetitions, or by grading the contraction technique. If there is no improvement in control, biofeedback or pelvic floor stimulation could be recommended.

Urge suppression technique is useful when you have a strong urge to go to the bathroom

  • Stop all movement immediately and stand still.
  • Squeeze your pelvic floor muscles quickly and tightly several times.
  • Take a deep breath and relax.
  • Concentrate on suppressing the urge feeling. Some women find distraction an effective technique.
  • When the strong urgency subsides, walk slowly and calmly to the bathroom.

The Knack Maneuver is a well-timed contraction of the pelvic floor muscles before and during events that increase pressure on the pelvic floor.

  • The Knack is a very useful technique for women with pelvic floor problems: control bladder leaks and withstand downward pressure on the pelvic floor.
  • Volitional contraction of the pelvic floor muscles just before and throughout a cough, can be used to reduce stress-related urine leakage significantly.

Kegel exercises for men can help improve bladder control and possibly improve sexual performance. Here's a guide to doing Kegel exercises correctly. Kegel exercises can strengthen the pelvic floor muscles, which support the bladder and bowel and affect sexual function. With practice, Kegel exercises for men can be done just about anytime.

Some men find these muscles by imagining that they are trying to stop the passage of gas. Squeezing these muscles gives a pulling sensation; these are the right muscles for pelvic exercises. It's important not to contract other muscles.