HOW TO EXERCISE THE PELVIC FLOOR MUSCLES?

Weakness of these muscles is a common cause of leakage of urine with physical stress,

e.g. laughing, sneezing or jumping.

(1) How to feel the pelvic floor muscles?

We do not usually consciously use the pelvic floor muscles and therefore, they are

not easy to identify in the beginning. These are the muscles that one uses to stop

from passing wind or faeces or stopping the passage of urine in the mid stream.

Therefore, you have to tighten the muscles around the anus. You can feel the anus

contracting. These are not the abdominal and leg muscles.

To confirm that you are contracting the correct pelvic floor muscles, try to stop

urination mid way. If you are not able to slow down the urination, it means that you

are not exercising the pelvic floor muscles.

You may also be able to use a pelvic floor muscle indicator inserted into the vagina

over a condom to see the strength of the contraction.

(2) Pelvic floor exercises

You should try to contract the muscles and hold on for as many seconds as you can.

Try to hold the contraction to a count of 10. Repeat 10x. Allow a 5 seconds rest in

between each squeeze. Do at least 3 sets per day, at your convenience, e.g. every

time you go to toilet, while waiting or watching TV, in the morning and before going

to sleep. The muscles can be contracted while you are lying down, then sitting and

later you can contract them even when you are standing. You should have a routine

for doing this exercise. You should feel an improvement after 3 months. Whenever

you need to sneeze or cough, you can prevent urine leaking by tightening your pelvic

floor muscles. You can also monitor the progress of your pelvic floor muscles by re-

inserting the pelvic floor meter over a condom to see the strength and duration of your

pelvic floor muscles. You can do this as often as you like with the continence nurse.

If you insert your finger into the vagina and try to grip the finger with the pelvic floor

muscles, you may appreciate an increase in strength of the pelvic floor muscles. You

can also test the strength of the pelvic floor muscles by insertion of various weights

of vaginal cones which usually come in sets with increasing weights of 1 to 5. These

cones are inserted like a vaginal tampon, leaving the string outside. You can insert

the vaginal weights and hold it while walking around for 15 minutes twice a day.

The strength of the pelvic floor muscles by itself cannot be improved by surgery nor

medication and therefore, pelvic floor exercise is the mainstay for long term control of

stress urinary incontinence.

DR CLARENCE LEI CHANG MOH, 李 长 茂 泌 尿 科 专 科 医 生

MBBS(Mal), Dip.Urology(London), FRCS(G), FRCS Urol(UK),FICS (USA) FEBU, FAMM

Consultant Urologist

Kidney & Urology Centre

Normah Hospital, Petra Jaya, 93050 Kuching

Tel: 082-440055 (Nurse Cannie Bong/Drusila Taylor ext. 264/269) Fax: 082-313494

For best results, please e-mail to: leicm@normah.com and cmlei@tm.net.my