II. Indications

  1. Stress Incontinence (includes Postpartum Incontinence)

III. Efficacy

  1. Effective at restoring postpartum continence
    1. Glazener (2001) BMJ 323:593-6 [PubMed]
  2. Effective in Urinary Incontinence in women
    1. Most effective when it is performed more intensely, more frequently and with individual supervision
    2. Todhunter-Brown (2022) Cochrane Database Syst Rev +PMID: 36053030 [PubMed]

IV. Mechanism

  1. Strengthens pubococcygeus Muscle
  2. Strengthens smaller pelvic floor musculature

V. Technique: Specific Kegal Exercises

  1. While urinating try to stop the flow of urine
    1. Start and stop it as often as possible
  2. Repeatedly contract as if you were stopping your urine
    1. Perform while not urinating
  3. Tighten Rectum as if avoiding to pass gas
    1. Contract the anus, but do not move buttocks

VI. Management: General Suggestions

  1. Hold Kegal Exercise for count of 5
  2. Advance to using weights within the vagina
  3. Perform Kegal Exercises as often as possible
    1. Study of Postpartum Incontinence recommended 100/day
    2. Glazener (2001) BMJ 323:593-6 [PubMed]
  4. Pick an activity you do often as a reminder
    1. Phone rings
    2. TV commercial
  5. Tighten your pelvic floor at stress times
    1. Before sneezing
    2. Rising from a chair
    3. Laughing
    4. Lifting an object

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