Pelvic floor muscle exercise
|Pelvic floor muscle exercise|
|Other names: Kegel exercise; pelvic floor exercise; pelvic muscle exercise; pelvic muscle training; pelvic floor physiotherapy; pelvic floor rehabilitation|
|Diagram of pelvic floor exercises|
|Indications||Urinary incontinence, pelvic organ prolapse|
|Steps||1) Squeeze pelvic floor muscles|
2) Hold for 3 seconds
3) Release and fully relax
4) Repeat 10 to 15 times, three times per day
Pelvic floor muscle exercise (PFME), also known as Kegel exercises, are exercises used to manage overactive bladder, urinary incontinence, and pelvic organ prolapse. It is a first line treatment for stress urinary incontinence. They may also help with sexual function. Both males and females may benefit. It often requires 3 to 6 weeks for benefits to occur.
It involves repeatedly contracting, holding for 3 seconds, and then relaxing the muscles that form the pelvic floor. It may be combined with biofeedback devices and done in combination with bladder training. Carrying out the exercises while lying, standing, and sitting is recommended. The exercises should be done as three sets of 10 to 15 repeats per day.
Care is recommended to not contract abdominal muscles or thigh muscles during the exercises. Excessive exercises are also discouraged. The pelvic floor muscles support the bladder, rectum, and uterus. Modern descriptions date from 1936 in the United Kingdom by physiotherapist Margaret Morris. It was subsequently popularized by American gynecologist Arnold Kegel in 1948. Descriptions of pelvic exercises; however, go back thousands of years.
Pelvic floor exercises can be included in conservative treatment approaches for women with urinary incontinence. There is tentative evidence that biofeedback may give added benefit when used with pelvic floor muscle training (PFMT). There is no clear evidence that teaching pelvic floor exercises alters the risk of stress urinary incontinence in men that develop this condition post prostatectomy.
In pregnant women, antenatal PFMT probably helps prevent urinary continence during pregnancy and up to six months after giving birth but for pregnant women who already have incontinence, it is not clear if antenatal PFMT helps to reduce symptoms.
Factors such as pregnancy, childbirth, aging, and being overweight often weaken the pelvic muscles. This can be assessed by either digital examination of vaginal pressure or using a Kegel perineometer. Kegel exercises are useful in regaining pelvic floor muscle strength in such cases.
Pelvic organ prolapse
Premature ejaculation is defined as when male ejaculation occurs after less than one minute of penetration. The perineal muscles are involved in ejaculation when they are involuntarily contracted. The ischiocavernosus muscle is responsible for male erection, and the bulbocavernosus muscle is responsible for ejaculation. By actively contracting the perineal muscles with Kegel exercises regularly, strength and control of these muscles increase, possibly aiding in avoidance of premature ejaculation.
Mechanism of action
Kegel exercises aim to improve muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Kegel is a popular[quantify] prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and childbirth. Various advisors recommend Kegel exercises for treating vaginal prolapse and preventing uterine prolapse in women and for treating prostate pain and swelling resulting from benign prostatic hyperplasia (BPH) and prostatitis in men. Kegel exercises may have benefits in treating urinary incontinence in both men and women. Kegel exercises may also increase sexual gratification, allowing women to complete pompoir and aiding men in reducing premature ejaculation. The many actions performed by Kegel muscles include holding in urine and avoiding defecation. Reproducing this type of muscle action can strengthen the Kegel muscles. The action of slowing or stopping the flow of urine may be used as a test of correct pelvic-floor exercise technique.
The components of levator ani (the pelvic diaphragm), namely pubococcygeus, puborectalis and iliococcygeus, contract and relax as one muscle. Hence pelvic-floor exercises involve the entire levator ani rather than pubococcygeus alone. Pelvic-floor exercises may help in cases of fecal incontinence and in pelvic organ prolapse conditions e.g. rectal prolapse.
Kegel exercises can train the perineal muscles by increasing oxygen supply and the strength of those muscles. The names of the perineal muscles are: ischiocavernosus (erection), bulbocavernosus (ejaculation), external sphincter of the anus, striated urethral sphincter, transverse perineal, levator of the prostate, and puborectalis.
Some devices, marketed to women, are for exercising the pelvic floor muscles and to improve the muscle tone of the pubococcygeal or vaginal muscle.
As of 2013 there was no evidence that doing pelvic floor exercise with weights worked better than doing Kegel exercises without weights; there is greater risk with weights, because a foreign object is introduced into the vagina.
During the latter part of the 20th century, a number of medical and pseudo-medical devices were marketed to consumers as improving sexual performance or orgasms, increasing "energy", "balancing hormones", and as having other health or lifestyle benefits. There is no evidence for any of these claims, and many of them are pseudoscience.
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