STRENGTHENING PELVIC FLOOR MUSCLES

Stress incontinence, the most common kind of urinary incontinence in women, usually results from weakening of the urethral sphincter. In men, it may sometimes occur after a radical prostatectomy.

You can help male and female patients prevent or minimize stress incontinence by teaching pelvic floor (Kegel) exercises to strengthen the pubococcygeal muscles. Here's how.

Learning Kegel exercises

First, explain how to locate the muscles of the pelvic floor. Instruct the patient to tense the muscles around the anus, as if to retain stools.

To identify this area initially, teach the patient to tighten the muscles of the pelvic floor to stop the flow of urine while urinating and then to release the muscles to restart the flow. Once learned, these exercises can be done anywhere. Although Kegel exercises shouldn't be done while urinating, they can be done at any other time.

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Establishing a regimen

Explain to the patient that contraction and relaxation exercises are essential to muscle retraining. Suggest that the patient start out by contracting the pelvic floor muscles for 5 seconds, relax for 5 seconds, and then repeat the procedure as often as needed.

Typically, the patient starts with 10 contractions in the morning and 10 at night, gradually increasing the relaxation and contraction time.

Advise the patient not to use stomach, leg, or buttock muscles. Also discourage leg crossing or breath holding during these exercises.

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