Kegel, or Pelvic Floor Exercises, to treat Urinary Incontinence & Pelvic Organ Prolapse

Kegel’s, or Pelvic Floor Exercises, are a way for women to improve their symptoms of urinary incontinence and or early pelvic organ prolapse. These exercises will improve the tone of the muscles of the pelvic floor.

There are a number of devices being marketed for women to use at home to aid in performing Kegel exercises. I personally think that most woman can learn to perform Kegel exercises on their own, thereby avoiding the cost and inconvenience of having to use a device.

When you are performing a Kegel exercise, you are tightening up a group of muscles collectively known as the levator muscles. These muscles help to “elevate” the pelvic organs. The muscles have the ability to contract both voluntarily and involuntarily. By exercising them voluntarily, you improve their baseline tone so that they will work when you need them (coughing, sneezing, laughing, etc.).

I think that an easy way to learn to contract the muscles is to take a moment when you have to void, and after you start voiding try to stop for a couple of seconds, then start again and finish. If done correctly, you will feel tightening at the bottom of your pelvis and possibly in your vagina. I suggest doing that only a few times to become familiar with the feeling of tightening. If you find yourself tightening your abdominal muscles, your thighs or you feel like you’re trying to deadlift a small car, you are using the wrong muscles. If you tighten the muscles while voiding you will probably notice at least a small decrease in the stream of urine. Don’t make a habit of doing Kegels every time you void though, as you may develop problems with emptying your bladder.

Once you feel like you’ve gotten the hang of it, you can do several sets a day. The sets should start out with 3 seconds of tightening followed by 3 seconds of relaxing, doing a total of 4 or 5 contractions per set. If you perform 3 or 4 sets every day, you can try to increase each contraction/relaxation by 1 second per week. The progression week by week will look something like this:

Week 1: 3s contract-3s relax-3s contract-3s relax-3s contract-3s relax-3s contract

Week 2: 4s contract-4s relax-4s contract-4s relax-4s contract-4s relax-4s contract

Week 3: 5s contract-5s relax-5s contract-5s relax-5s contract-5s relax-5s contract

If you are doing the exercises to help with urge incontinence, after you’ve done them for a few weeks hopefully you will find that when you get the urge to void, if you do a Kegel for a few seconds, the urge will decrease so you have more time to make it to the restroom.

For many women, Kegel exercises are a quick, easy, low-cost, effective way to manage their symptoms of urinary continence and or pelvic organ prolapse. If you’ve done the exercises consistently for 4 to 6 weeks and haven’t noticed much of an improvement, I recommend you visit your doctor to discuss next steps.


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Dr. Kevin O’Neil

Dr. Kevin O'Neil - Urogynecology