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This is the exercise which, when done faithfully and correctly, can help decrease the urgency a patient may have and help with both urge incontinence and stress incontinence.
Pelvic Floor Exercises (Kegel exercises)
This is the exercise which, when done faithfully and correctly, can help decrease the urgency a patient may have and help with both urge incontinence and stress incontinence. The pelvic floor muscle is like a hammock that stretches from the pubic bone in the front to the tailbone in the back. This set of muscles supports the organs of the pelvic region, which include the bladder, large intestines and uterus. Since this muscle is often not exercised, it is generally weak to begin with, which contributes to urinary symptoms. Childbirth will weaken this muscle more because during vaginal delivery, the child's head and body push under the pelvic floor muscle and stretches it extensively which causes temporary additional damage/weakening. Learning to do these exercises can help with incontinence, however to perform these exercises effectively the patient must first identify the correct muscles.
Two methods of identifying the correct muscles:
One key point is that patients do not want to use other muscles, such as the abdomen, legs or buttocks. It is important to isolate the muscles only to further increase their strength. If you are moving these muscles or holding your breath, you are probably trying too hard!
Concentrate just on the pelvic floor muscles and do the best you can. This contraction will get easier with practice. One exercise program is described below:
It may take awhile to work up to a 10 second hold. In the beginning, you will probably not be able to hold for more than five or six seconds and that is all right. Between each contraction, relax for 10 seconds. This allows the muscle to rest adequately to be able to perform well for the next contraction. If you do not relax the muscle well enough, the muscles will tire quickly. By faithfully doing your Kegel exercises, you should see an improvement in your symptoms starting in four to six weeks.
Urethral Opening Occlusion Devices
There are several new non-surgical products on the market for female stress urinary incontinence. Brand names are listed:
Collagen is a naturally occurring protein found in humans and animals. When it is injected into the tissue around the urethra, it adds bulk and helps it close tightly to prevent urine leakage, especially urine leakage associated with activity (Stress Urinary Incontinence). Most patients will leak much less or not leak at all after collagen therapy. Some patients will need to have one or more injections done at a later date because the body will absorb some of the collagen material. The length of time between injections varies with each patient. Some need to be re-injected after a few months and some after a few years.
Â© John Miklos MD ,Neeraj Kohli, MD