Kegel exercises are done by tightening and relaxing the PC or pubococcygeus muscles located in the pelvic floor.
While many women are familiar with Kegel exercises for strengthening their pelvic floor muscle, Kegel exercises are also important for men. Keeping the pelvic floor muscle strong can be especially important for men prior to and after prostate surgery, for those with overactive bladder (OAB) and for those with chronic conditions, such as diabetes. Men who have urinary and/or fecal incontinence and light leakage of urine right after urinating will often also benefit from Kegel exercises.
Kegel exercises, repeated consistently and done correctly, are like any other exercise – they keep muscles strengthened and performing optimally. When the muscles are strong, they support the bladder and bowel, keeping these organs in their proper place and allow you to use additional exercises to help you control your symptoms. Women often are told to do Kegel exercises when they enter their childbearing years, and then continue doing them throughout the rest of their lives. Women learn early on that a strong pelvic floor can ward off or improve urine leakage. The same is true for men.
What Are Kegel Exercises and How to Do Them
Kegel exercises are done by tightening and relaxing the muscle of the pelvic floor, which is called the PC or pubococcygeus muscle. Just as one strengthens biceps through repetitions (or reps) of lifting weights, this muscle is strengthened by doing 10-20 reps of tightening and relaxing — done three to four times a day. At the beginning, you will most likely only be able to do just a few contractions of the muscle a couple of times a day. And that’s OK because you are building your strength! You will get stronger over time and eventually be able to do these sets of exercises several times a day.
First, and very importantly, you must locate the correct muscles to exercise. You can locate these muscles by:
Try to stop or slow down the flow of urine while you are urinating (peeing). However, do not tense the muscles in your buttocks, legs or abdomen, and do not hold your breath. When you have significantly slowed or stopped the urine flow, you have found the right muscles. Once you identify the correct muscle group, do not practice the exercises by slowing down or stopping your urine flow.
Alternatively, you can try tightening your rectum ONLY, as if you are trying to stop the passing of gas or pinching off a stool, but do not tense up any other muscles (buttocks, abdomen or legs) and continue to breathe normally. It is also fine to practice Kegel exercises this way.
You will know when you have found the right muscle because you will feel a pulling upward and inward in your abdomen. Your penis and testicles will move slightly up and down as you tighten and relax these muscles. Nothing else should be moving!
NOTE: If you feel uncertain that you have found the proper muscles, contact your healthcare provider for assistance (this could be your physician, a physical therapist, physician’s assistant (PA), nurse practitioner (NP) or specialized nurse). If you have trouble locating this muscle, they may recommend the use of biofeedback to ensure that the correct muscle is being contracted and strengthening the pelvic floor is achieved.
When you first are learning these exercises, it is often easiest to perform them while lying down in bed. Later on, when you are stronger, try them while sitting, standing and even walking. While lying down, with your knees bent and slightly apart, tighten your pelvic floor muscle that you identified previously, hold the contraction for three to five seconds, and then relax for three to five seconds. Repeat this a few times until you can repeat it easily 10-20 times. While you are doing the exercises, be sure that you continue to breathe and do not tighten your legs, buttocks or your abdomen. Only your pelvic floor muscles should be getting a good workout! The rest of those muscles can get a workout at your local gym.
Make Kegel exercises a part of a daily routine so that you do them consistently. For example, do them while you are brushing your teeth. Do a set after you urinate or have a bowel movement. Contract that pelvic floor before sneezing, coughing, laughing or doing any heavy lifting. If you are doing Kegel exercises properly, no one else will be aware of your doing these exercises, which means eventually you can do them almost anywhere and anytime.
Kegels Also Help Incomplete Emptying of the Bladder
Sometimes, due to multiple medical conditions or surgical complications, the bladder does not empty completely. While Kegel exercises help control urine loss, these exercises can also help assist in urine emptying. Once you can identify the pelvic floor muscle, learn to relax the muscle and continue to relax the muscle while attempting to empty the bladder again. Additionally, try to empty the bladder in a different position such as: sitting down on the toilet, sitting on the toilet facing backwards, and squatting over the toilet. In some cases, you may need to use an intermittent catheter to empty your bladder a couple of times a day. The catheter use may be temporary or permanent. You and your physician will need to discuss catheter use if this treatment option is necessary.
Expected Results
It may take about six weeks of regular exercise before you will see less frequent urine leakage. To continue the benefits of a strengthened pelvic floor, Kegel exercises must be a permanent part of your daily routine.
Men who are going to have prostate cancer surgery should begin doing Kegel exercises as soon as they learn they are going to have surgery. While a catheter is in place, you should NOT do the exercises. But, once the catheter is removed, and your physician says it is OK, start doing your exercises again. These exercises should improve your control. While Kegel exercises may not completely stop urine leakage, they should make your urine leakage less and you may regain continence more quickly. Discuss your expected recovery progress with your surgeon and healthcare team.
Please understand that not every man will regain 100% continence after doing Kegel exercises, as there are so many variables for each person’s circumstance. Some men will not experience any incontinence issues after building strength in their pelvic floor area, and others will experience a major improvement, but still have some leakage. Each individual is unique. How your body responds will be different from someone else. Kegel exercises can be an important part of your surgical recovery process or overall incontinence treatment plan, but they may not be a complete cure.
For more general information on Male Urinary Incontinence, click here.
Medical Reviewer: Francie Bernier, PhD, RN
Dr. Bernier
Dr. Bernier is Assistant Professor of Nursing at Shenandoah University, Leesburg, Virginia, at the Eleanor Wade Custer School of Nursing. Her areas of expertise include non-surgical care for pelvic floor dysfunction. Dr. Bernier is President of the DC Chapter of the Society of Urologic Nurses (SUNA) and is an Associates Legislative Representative for the Society of Urologic Nurses and Associates, is a Liaison to the American Urologic Association for the Society of Urologic Nurses and Associates, and is a Member of Sigma Theta Tau (Nursing Honor Society).