Kegel Exercises
Strengthen Your Bladder and Pelvic Floor
Common bladder and pelvic floor disorders include:
- Urinary incontinence
- Stress incontinence (accidental urination)
- Urge incontinence (overactive bladder)
- Fecal incontinence
- Pelvic organ prolapse
- Fistulas
- Complex benign conditions of the vagina and urethra
Girl-talk. It's what women do. This is especially true when a pregnancy or new baby enters our lives. We talk about so many intimate details of our lives with our girlfriends, but one area often remains untapped…that is, "What the heck is going on with my bladder?"
There is no need to be discreet in this area. Bladder and pelvic floor health is very important to a woman's overall good health. Here is the rundown on what you should know about what's going on ‘down-there.' And if you are having problems in this area, we hope you'll talk to not only your friends—because chances are they are having similar issues—but most importantly, talk to your health care provider.
Bladder and pelvic floor disorders, also known as urogynecologic disorders, include any pain or dysfunction in the area of the uterus, cervix, vagina, bladder, or rectum.
As a woman ages, the pelvic floor naturally weakens. The pelvic floor is a network of muscles, ligaments, and tissues that act like a hammock to support a woman's uterus, cervix, vagina, bladder, and rectum. A number of factors—including pregnancy—can weaken the pelvic floor even further, causing pain or dysfunction of the pelvic organs. Fortunately, there are preventive exercises, simple solutions and new treatments available to treat bladder and pelvic floor disorders.
Because of the embarrassment associated with urinary incontinence and other bladder and pelvic floor disorders, many women suffer in silence. Daily tasks may become more difficult, since coughing, laughing or sneezing may trigger an accident. Fortunately, there is no reason for women to suffer these conditions; nearly 85 to 90 percent of all urogynecologic conditions can be diagnosed and successfully treated through minor lifestyle changes, medications, or surgery.
"Urinary incontinence and pelvic floor disorders are not part of normal aging," says Megan Schimpf, MD, a specialist in urogynecology and pelvic reconstruction at Pennsylvania Hospital. "When these problems begin to interfere with a woman's life, she should discuss them with her doctor and a urogynecologist."
Urinary incontinence
Urine leakage, also known as urinary incontinence, is a common problem, but it is not normal. A careful review of the problem and symptoms, a physical exam, and in some cases, urodynamic testing are used to diagnose the underlying problem.
Preventing urinary incontinence
During pregnancy, doctors often recommend performing certain exercises, called Kegel exercises, to help strengthen the pelvic floor and prevent urinary incontinence after pregnancy.
Helpful Tip...
Kegels are the tightening of the area between the thighs to help restore the tone of the muscles that surround the opening of the urethra, vagina and anus. An easy way to tell which muscles you should exercise is to perform the Kegel technique while urinating. If you can stop the flow of urine when tightening, then you know that you are contracting the correct muscles. Although this is a good check for accurate Kegel technique, it is not recommended that you perform your Kegel exercises while urinating.
There are several kinds of Kegels that you can try:
The Basic Kegel
Squeeze and release the pelvic floor muscles. Start gradually and build up repetitions over time.
Elevator Kegels
Visualize the muscles of your vagina as a building, with the base of your pelvic floor as the "lobby" and the top floor at your belly button. Raise the elevator slowly (tighten the muscles) from the bottom floor to the top, give a slight hold and bring the elevator back down, slowly relaxing your muscles from top to bottom.
Sustained Kegels
Contract the pelvic floor muscles and hold for a count of 10. Repeat 10 times. If you cannot hold them this long initially, hold them as long as you can. Eventually, you will be able to do 10-second holds.
Progressive Kegels
Squeeze briefly and hold for five seconds. Then squeeze harder and hold for five seconds. Squeeze as hard as possible and hold for five seconds. Release a little, hold for five. Release a little more, hold for five. Release completely.
Treatments for urinary incontinence
Women suffering from urinary incontinence may be effectively treated through physical therapy designed to strengthen the pelvic floor muscles, or by a minimally invasive surgical procedure called tension-free vaginal tap (TVT). During the TVT procedure, a mesh sling is used to stabilize the urethra so that it doesn't open under pressure.
Other treatment options for urinary incontinence include medication and biofeedback. While some patients find that certain drugs work better than others, some people experience little or no relief from any of the medications. For these women, the urogynecologists at Penn are having success with the use of electrical stimulation of the sacral nerves or surgery.
"The device works like a pacemaker for the bladder," says Gina Northington, MD, PhD, a urogynecologist at the Hospital of the University of Pennsylvania. If the device works for the patient, it is permanently implanted. If the patient does not find relief, it can be removed."
"Surgery is also an option for treating both incontinence and prolapse," says Dr. Schimpf. "In addition to open abdominal surgery, we may use vaginal surgery, laparoscopic surgery or robotic-assisted surgery. Depending on the specific problem each patient has, we can choose a treatment plan that best fits her lifestyle."
The advantages of robotic-assisted surgery include smaller incisions, quicker recovery times and better cosmetic results while using the same concepts employed in open abdominal surgery. Vaginal surgery also offers quicker recovery times with no abdominal incisions.
A number of factors—including pregnancy—can weaken the pelvic floor even further, causing pain or dysfunction of the pelvic organs. Fortunately, there are preventive exercises, simple solutions and
new treatments available to treat bladder and pelvic floor disorders.
