Pelvic muscle exercises, commonly known as Kegel exercises, are an important part of the behavioral treatment techniques that can be used to help increase bladder control and decrease bladder leakage. As with any treatment option, this technique requires conscious effort and consistent participation on the part of the patient. These exercises have been shown to improve mild to moderate urge and stress incontinence.

There are 2 types of pelvic floor exercises you need to do:

• The first exercise works on the holding ability of the muscle (building a strong dam to hold back the urine). It is done by slowly tightening, lifting, and drawing in the pelvic floor muscles and holding them to a count of five. If you feel the contraction letting go, just re-tighten the muscles.
• The second type of exercise is a quick contraction. The muscles are quickly tightened, lifted up, and let go. This works the muscles that quickly shut off the flow of urine (like a faucet). This helps to prevent accidents.

It is important to exercise the muscles of your pelvic floor on a regular basis. Do not tense or contract your legs, buttocks, or belly. Holding your breath makes it difficult for the muscles to work correctly. Start with a set of 10 repetitions of each type of exercise and do them two or three times per day.

It is recommended that you try to do a total of 30 to 80 repetitions per day. Progress at your own pace. The amount of time needed to show improvement varies from person to person. Increase the exercise periods and/or the number or exercise repetitions as you notice improvement, but remember, you need to continue challenging the muscles to see improvement.

Your bladder and bowel control can begin to improve in three to four weeks. However, some people take three to six months to see major improvement. If you keep a voiding diary, you may begin to notice fewer marks in the bladder leakage column or a smaller amount of urine loss.

In the beginning, it is best to do the exercises lying down so that there is little stress on the muscles. Bend your knees or elevate your legs on a pillow or stool, so you are comfortable and your legs are relaxed.

When to do Pelvic Muscle Exercises?

Pelvic muscle exercises require a lifetime commitment. As your pelvic muscles strengthen they can be used more and more in your daily routine. Pelvic muscle contractions should be performed prior to or during any activity that causes leakage. Some helpful hints are to always:

• Tighten the pelvic muscles before you lift, cough, or sneeze to help you hold back the flow of urine. Remember, learn to squeeze before you sneeze.
• Tighten the muscles before you clear your throat or blow your nose.
• Use your pelvic muscle exercises to help you suppress a strong urge to urinate when it comes on.
• Incorporate pelvic muscle exercises into a regular exercise program