Rigi10™ Malleable Penile Prosthesis
Also Known As
Pelvic floor muscle training (PFMT), pelvic floor exercises, pelvic muscle exercises (PME), pubococcygeal exercises
Definition
Kegel exercises, first described by Arnold Kegel in 1948, are specialized physical exercises designed to strengthen the pelvic floor muscles.1 These exercises involve the systematic contraction and relaxation of the pelvic floor muscles (PFM), which consist of the levator ani (including puborectalis, pubococcygeus, and iliococcygeus muscles) and coccygeus muscles.2 The pelvic floor muscles form a supportive hammock-like structure that extends from the pubic bone to the coccyx, supporting critical pelvic organs including the bladder, uterus, small intestine, and rectum.3
The primary purpose of Kegel exercises is to improve pelvic floor muscle tone, strength, and function, thereby enhancing urinary and fecal continence, supporting pelvic organs, and potentially improving sexual function.4 These exercises can be performed through alternating fast contractions (quickly tightening and relaxing) and slow contractions (holding the contracted muscles for extended periods), which respectively train the muscles to respond to sudden increases in intra-abdominal pressure and build overall strength.5 The perineometer, also called the vaginal manometer, can be used to measure contraction strength and guide proper technique.1
Clinical Context
Kegel exercises are considered first-line therapy for various pelvic floor disorders due to their non-invasive nature and minimal side effects.4 They are primarily indicated for urinary incontinence (UI), with studies showing that stress urinary incontinence responds better to these exercises than mixed UI.5 The prevalence of UI among women ranges from 25% to 45%, with higher rates in older populations, making Kegel exercises a significant therapeutic intervention.3
Pelvic floor muscle weakness can result from multiple factors, including pregnancy, vaginal delivery, obesity, diabetes mellitus, aging, and gynecological surgeries.3 Research has demonstrated that women with UI experience decline in muscle tone, maximal strength, rapidity of contraction, and endurance of the pelvic floor.3 Regular performance of Kegel exercises has been shown to improve pelvic floor muscle strength, enhance quality of life, and reduce urinary symptoms.5
Kegel exercises are also effective in preventing and treating pelvic organ prolapse (POP), which affects more than half of women over 50 years.6 Studies have shown that pelvic floor muscle training not only improves the stage of POP but also reduces symptom frequency and elevates the bladder and rectum through improved muscle strength and endurance.6
Additionally, these exercises have demonstrated efficacy in improving sexual function in both women and men. For women, pelvic floor muscles play a significant role in orgasmic function, and strengthening these muscles can enhance sexual sensation and satisfaction.3 In men, systematic reviews have shown that pelvic floor muscle training can improve erectile dysfunction and premature ejaculation.7
For optimal results, Kegel exercises should be performed regularly as a lifelong practice, typically in multiple sets throughout the day in various positions (lying, sitting, standing).8 While there is no fixed protocol, the fundamental approach involves identifying the correct muscles, performing proper contractions, and maintaining consistency.3