Urinary Incontinence

Tamara Dickinson, RN, CURN, CCCN, BCIA-PMDB

I’m trying to do Kegel exercises, but I’m not sure I’m doing them right. How do I know?

Pelvic muscle exercises (or Kegel exercises) use repetitive and selective voluntary contractions and relaxation of the pelvic floor muscles. This can increase the support at the outlet of the bladder and aid in techniques to suppress urgency. Improvement persists over time but patient motivation is very important.

Some women feel that they are contracting their vagina while some feel it more around the rectum. Women should not be squeezing their buttocks and should not be tightening their abdominal muscles. No one should be able to tell that you are doing a pelvic muscle exercise.

I often instruct my patients to sit on a firm chair so that the pelvic floor muscles have support. I then have patients rest their hands across their abdomen, and remember to keep breathing while trying to tighten their pelvic muscles. By remembering to breathe, they are less likely to tighten their abdominal muscles. Also, while sitting on a firm chair, they should not "rise" up from the chair when they squeeze. That would be a sign they are tightening their buttocks.

It is important that the patient not try to hold the squeeze longer than what is comfortable. It takes time to strengthen and condition these muscles, just as it does for any other muscle.

If a patient is able to stop the flow of urine, she is using the right muscle group. But this shouldn’t be the way you practice your exercises routinely, as you can develop difficulty in emptying your bladder.

Tamara Dickinson, RN, CURN, CCCN, BCIA-PMDB
President, Society of Urologic Nurses and Associates
www.suna.org