From the Guidelines
Pelvic floor exercises are commonly needed for patients experiencing urinary incontinence, fecal incontinence, pelvic organ prolapse, and postpartum recovery, as they strengthen the muscles that support the bladder, uterus, small intestine, and rectum. These conditions often require a comprehensive management approach, and pelvic floor exercises are a first-line treatment option, as evident from the study published in the European Urology journal 1. The exercises work by improving muscle tone, endurance, and coordination of the pelvic floor muscles, which form a hammock-like structure supporting pelvic organs and controlling bladder and bowel function.
Common Reasons for Pelvic Floor Exercises
- Urinary incontinence, particularly stress incontinence that occurs when coughing or sneezing
- Fecal incontinence
- Pelvic organ prolapse
- Postpartum recovery
- Prostate issues, including those recovering from prostate surgery
- Chronic constipation
According to the study published in the Annals of Internal Medicine journal 1, pelvic floor muscle training (PFMT) is an effective treatment option for urinary incontinence, and it involves instruction on the voluntary contraction of pelvic floor muscles (Kegel exercises). The American College of Radiology also recommends PFMT as a first-line treatment option for pelvic floor dysfunction in females 1.
Typical Regimen for Pelvic Floor Exercises
- Identifying the correct muscles (those used to stop urination midstream)
- Performing sets of contractions held for 5-10 seconds, followed by relaxation
- Repeating 10-15 times, three times daily for at least 6-8 weeks to see improvement
It is essential to note that pelvic floor exercises should be tailored to individual patient characteristics, preferences, and severity of symptoms, as highlighted in the study published in the European Urology journal 1. Additionally, the exercises should be performed under the guidance of a healthcare professional to ensure proper technique and maximum benefit.
From the Research
Common Reasons for Pelvic Floor Exercises
Patients may need pelvic floor exercises for various reasons, including:
- Pelvic floor dysfunction, which can cause voiding and defecation problems, pelvic organ prolapse (POP), sexual dysfunction, and pelvic pain 2
- Urinary incontinence, which can be improved or cured with pelvic floor physical therapy (PFPT) 2
- Fecal incontinence, which can be improved with PFPT 2
- Peripartum and postpartum pelvic floor dysfunction, which can be treated with PFPT 2
- Hypertonic pelvic floor disorders, including pelvic floor myofascial pain, dyspareunia, vaginismus, and vulvodynia, which can be improved with PFPT 2
- Neurogenic detrusor over-activity (NDO) and incontinence in patients with spinal cord injury, which can be improved with pelvic floor muscle training (PFMT) 3
- Lower urinary tract dysfunction in multiple sclerosis patients, which can be improved with PFMT 4, 5
- Sexual dysfunction in multiple sclerosis patients, which can be improved with PFMT 5
Risk Factors for Pelvic Floor Disorders
Certain risk factors can increase the likelihood of developing pelvic floor disorders, including:
- Vaginal birth, which is the largest modifiable risk factor for prolapse and an important contributor to stress incontinence 6
- Forceps delivery, occiput posterior birth, older maternal age, long second stage of labor, and birthweight of >4000 g, which can increase the risk of levator injury 6
- Spinal cord injury, which can cause NDO and incontinence 3
- Multiple sclerosis, which can cause lower urinary tract dysfunction and sexual dysfunction 4, 5