Kegel Pelvic Floor Muscle Exercises to Strengthen the Bladder Sphincter Muscle and Improve Continence

Pelvic muscle exercises strengthen the pelvic floor muscles that relax and contract under your command to control the opening and closing of your bladder. When these muscles are weak, as can occur with age or enlargement of the prostate, urine leakage may result. Exercise, when done correctly, will add muscle strength and bulk and, with time, should allow you to regain complete bladder control. The bladder sphincter, just like the biceps muscle of an athelete, will gain endurance and strength with regular exercise.

Muscles tend to grow weak when they are not used, so Kegel exercises can be done to prevent leakage of urine in the future. If you are going to have a prostate operation, it is best to begin the exercises several weeks before surgery. The exercise only works, of course, if the correct muscle is being contracted. Begin by positively identifying the muscles to be exercised.

As you begin urinating, try to slow or stop the urine. The muscle that does this is the muscle to be exercised. It is best to do it without tightening other muscles, such as your abdomen, legs or buttocks. You may feel the penis being pulled inward and upward as you contract the bladder sphincter muscle. The bladder sphincter is closely associated with the rectal sphincter, and you may exercise by tightening the anus. It is what we do naturally to avoid passing gas at inappropriate times, such as in an elevator.

Once you have correctly identified the sphincter muscle set aside time each day for two to four exercise sessions (morning, midday, and evening). It may help to tie it to something you do regularly such as take medicine, brush your teeth, or wait at stoplights. Begin with a slow squeeze of the muscle and hold it for a slow count to five or more. Wait for a count of 5 or more and then repeat. Do that 6 times in the beginning, to make a set of 6, and increase the number of gradually over the next several days. When you get to 12 and are comfortable with that, go to two sets of 8, work up again to 12, and then go to 3 or more sets. It is the long, slow, hard contraction that is most effective and most important, but the sphincter has two types of muscle fibers, "slow twitch" and "quick twitch". It you want or need advanced exercise you can also contract the fast twitch muscles by doing a series of quick squeezes of the muscle. This may help if your bladder is having strong contractions and you have difficulty making it to the restroom in time.

Tips

• If your pelvic floor muscles are very weak, you should begin by contracting the muscles for only 3 rather than 10-20 seconds and may need to do fewer repetitions, sometimes only once a day. If you overdo the exercise your leakage may increase for a time.
• If you are not making progress you may not be contracting the correct muscles. Your urologist can check you to be sure you are working the right muscle.
• Full control of urination may take as long as a year to return completely following surgery, but be assured that exercise of the correct muscle should resolve the problem and make pads unnecessary.

Created: 8/15/2007