WHAT ARE KEGEL EXERCISES?

Kegel exercises were developed as a nonsurgical treatment for urinary incontinence in the 1940s by a gynecologist named Dr. Arnold H. Kegel. These exercises were designed around the findings that strengthening the pelvic floor, vaginal wall, and surrounding supportive systems could prevent urinary incontinence and genital organ prolapse.

While Kegel exercises are generally considered very easy to do, it’s essential to locate the right set of muscles to exercise in order to get results. Experts recommend that women utilize the techniques of pretending they are trying to avoid passing gas or pretending to tighten the vagina around a tampon in order to identify the muscles that need to be engaged during Kegels.

To do a Kegel, contract your pelvic floor muscles for three to five seconds before relaxing for three to five seconds. For best results, repeat the contract-relax cycle 10 times per session. While engaging pelvic muscles, it’s important to keep abdominal, leg, and buttocks muscles relaxed. The pelvis should not be visibly moving during Kegel routines.

BENEFITS OF STRONG PELVIC FLOOR MUSCLES

Kegel muscles help to strengthen the muscles that support the bladder, uterus, small intestine, and rectum. In addition to preventing incontinence, this type of pelvic floor muscle training can also improve quality of life.

Improved Bladder Control

Kegel exercises are ideal for people struggling with something called stress incontinence. Stress incontinence occurs when a few drops of urine leak as a result of coughing, laughing, sneezing, or bending to stretch or lift heavy objects. Kegels can also help to reduce the strong, sudden urge to urinate called urge incontinence that can also result in small urine leaks.

Better Sexual Function

Using Kegel exercises to strengthen the pelvic floor muscles can lead to improved sexual function and greater sexual satisfaction. For women, stronger pelvic floor muscles can improve sexual arousal and increase orgasm intensity. In addition, Kegels also increase blood flow to the pelvic area to boost overall arousal and sensitivity.

Faster Postpartum Recovery

After getting clearance from your doctor, beginning Kegel exercises a few days or weeks following vaginal or C-section delivery can help to speed up recovery. During pregnancy, a combination of the increased weight of a growing baby, hormonal changes that soften pelvic ligaments, and an expanding uterus will generally weaken the pelvic muscles. Kegel exercises can help to strengthen muscles that have stretched or become weak during pregnancy and delivery.

Better Bowel Control

Kegels can help with improving bowel control and stopping fecal incontinence. By contracting and relaxing sphincter muscles, Kegels can make it easier to hold in stool and gas. In addition, strengthening pelvic floor muscles provides better support for the rectum.

Related: When Do You Need Vaginal Rejuvenation?

Pelvic Floor Muscles

FASTER ALTERNATIVES TO KEGEL EXERCISES

Kegel results can vary depending on a person’s muscle strength, how consistent they are with exercises, and the severity of the pelvic floor damage. While Kegels are considered ideal for minor incontinence, they may not work as effectively or quickly enough to produce the results someone suffering with more extreme incontinence or muscle weakness would like to achieve. Several surgical and laser procedures are available for more extreme situations.

Vaginoplasty

Vaginoplasty is any surgical procedure used for the construction of the vagina. Vaginoplasty is commonly used to repair pelvic organ prolapse. It can also be used to repair stretching and looseness following childbirth, restore shape and appearance following radiation or other medical treatments, or correct congenital abnormalities affecting the function or appearance of the vagina.

Vaginal Rejuvenation

Vaginal rejuvenation refers to a number of procedures that improve appearance, function, or comfort. In many cases, several rejuvenation procedures are combined. This might include labiaplasty or surgical hood reduction. There are even options for noninvasive vaginal laser rejuvenation. For example, laser treatments that trigger collagen production, radiofrequency (RF) vaginal rejuvenation that uses RF waves to heat and tighten tissue, and platelet-rich plasma (PRP) injections that use platelets from a patient’s own blood to promote tissue healing.

Perineoplasty

Perineoplasty is a surgical procedure that’s commonly used to repair damage done by childbirth or trauma. This procedure repairs and tightens muscles and tissue in the area between the vagina and anus that’s known as the perineum. In addition to restoring the appearance of the perineum, perineoplasty can help to reduce urinary incontinence and restore sexual function.

Are you interested in learning more about Kegel exercises and other options for tightening the pelvic floor? For more than two decades, Dr. Michael Tahery has been a leading obstetrician-gynecologist (OB-GYN) and urogynecologist serving the Los Angeles and Glendale areas. Dr. Tahery offers the latest in surgical and laser procedures. Contact Dr. Tahery’s office for a consultation today.

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Pelvic reconstructive surgery aims to repair those abnormalities, helping women reclaim their bodies and confidence.

Pelvic Organ Prolapse

A urogynecologist in Los Angeles can perform reconstructive surgery to repair pelvic organ prolapse. The pelvis holds many crucial organs like the rectum, bladder, uterus, and cervix. A network of muscles and tissues forms a hammock-like support structure called the pelvic floor.

Unfortunately, the muscles in the pelvic floor can weaken after childbirth or a hysterectomy. Some women will also experience weakened muscles after menopause or significant weight gain or loss. When the pelvic floor becomes compromised, your pelvic organs can prolapse, essentially slipping out of position and pressing into the vagina.

A pelvic organ prolapse typically creates a bulge in the vagina. Pain, discomfort, urinary incontinence, difficulty emptying the bowel, and a lack of bowel control are common symptoms.

Physicians classify pelvic organ prolapse differently depending on the organ that moves out of position.

Vaginal Prolapse

Vaginal prolapse is when the top of the vagina, also known as the vaginal vault, begins to sag into the vaginal canal. In severe cases, the vaginal vault can drop so low that it bulges outside the vaginal opening.

Common symptoms here include a feeling of fullness and unusual pressure in the vagina.

Rectocele

This type of prolapse involves the rectum. Usually, a thick fibrous tissue wall separates the vagina and the rectum. But when prolapse occurs, part of the rectum moves and pushes the back wall of the vagina forward to create a prominent bulge.

In addition to pressure, a rectocele typically increases abdominal gas and emptying the bowel more challenging.

Cystocele

A cystocele is when the bladder drops or sags into the vagina. Like a rectocele, the tissue wall separating the bladder and the vagina weakens, causing the bladder to slip out of place.

A common symptom with a cystocele prolapse is urinary incontinence.

Uterine Prolapse

Uterine prolapse occurs when the uterus drops down into the vagina. Like other prolapses, it causes pressure, vaginal fullness, and bulging. However, it may also cause lower back pain, urine leakage, incontinence, and constipation.

RELATED: Pelvic Floor Disorder Symptoms In Women

Causes of Pelvic Organ Prolapse

There are many potential causes of prolapse that require pelvic reconstructive surgery. While the pelvic floor is resilient, it can only take so much. Anything that causes excessive strain or pressure could cause a prolapse. Here are some of the most common culprits.

Pregnancy and Childbirth

When you become pregnant, the pelvic floor works harder than ever before. It stretches to make room for your growing baby, which often causes the muscles to weaken.

During childbirth, it experiences even more stretching and strain. Even cesarean delivery can weaken those crucial muscles.

Chronic Stress

Patients with chronic constipation, cough, untreated asthma, heavy and prolonged straining movements also can damage the connective tissue support of the organs surrounding the vagina. 

Genetics

Interestingly enough, genetics can play a part in pelvic organ prolapse. Your genes influence the strength of your bones and muscles. Unfortunately, prolapse becomes a hereditary issue for some women, increasing the chances that they’ll need pelvic reconstructive surgery at some point.

Obesity

Lastly, obesity can be a significant factor in pelvic organ prolapse. Intra-abdominal pressure strains the pelvic floor muscles and the connective tissue. Women who have a higher BMI are at a greater risk of prolapse.

RELATED: What Causes Urinary Incontinence In Women?

Pelvic Reconstructive Repair Options

If you’re suffering from pelvic organ prolapse, many surgical options are available. Dr. Tahery, a urogynecologist in Los Angeles, can perform a variety of minimally invasive repairs based on your unique needs. These repairs aim to fix the prolapse and rebuild your pelvic floor. Here are some of the ways a surgeon might approach that task.

Native Tissue Repair Surgery

This technique is usually a suitable option for women with healthy workable tissue. It’s a versatile option because it can effectively treat all types of pelvic organ prolapse.

During pelvic reconstructive surgery, a surgeon will use the patient’s existing tissue to fix the damaged portions of the pelvic floor. For a cystocele repair, the surgeon will move the bladder back into place and tighten the front wall of the vagina. For Rectocele, they’ll pull the tissue between the rectum and vagina together to eliminate bulging and promote healing.

In vaginal and uterine prolapse cases, the focus is on damaged ligaments. The surgeon may shorten and tighten overstretched ligaments to ensure that the uterus and vaginal vault stay in place.

Native tissue repair is minimally invasive and typically only involves small incisions in the vagina or abdomen.

Sacrocolpopexy Surgery

Sacrocolpopexy is a pelvic reconstructive surgery that can help women with more advanced cases of prolapse. It’s often the technique of choice for women who experience prolapse after a hysterectomy. Sacrocolpopexy can also correct vaginal prolapse and severe cases of uterine prolapse.

To address the symptoms of pelvic organ prolapse, surgeons utilize surgical mesh. They may attach it to the vagina and sacrum to achieve the correct anatomical support.

There are a few ways to perform sacrocolpopexy. A urogynecologist in Los Angeles can perform it traditionally with a large horizontal incision in the abdomen or with robotics and small incisions. Either way, the goals, and techniques are the same.

Transvaginal Graft Surgery

Transvaginal graft surgery can help patch and reinforce weak areas of the pelvic floor tissue. It may also help with incontinence issues and strengthen the vaginal wall. The procedure is versatile, addressing most types of prolapse.

Surgeons can utilize a synthetic mesh or a biological one. The surgery is relatively straightforward and usually occurs through incisions in the vagina.

Pelvic reconstructive surgery can make a world of difference in your overall health and well-being. Pelvic organ prolapse can be a traumatic experience that dramatically affects a woman’s quality of life. Luckily, there are ways to address the problem and deal with the uncomfortable symptoms.

If you’re struggling with the effects of pelvic organ prolapse or other pelvic floor disorders, reach out to the offices of Dr. Tahery. Dr. Michael Tahery is an experienced urogynecologist in Los Angeles with decades of experience helping women just like you. He’s well-versed in pelvic reconstructive surgery and can help you get the relief you need. Give our offices a call today and schedule your consultation.

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In most cases, incontinence isn’t a life-threatening ailment. However, it can negatively impact a woman’s quality of life. Women are twice as likely to suffer from this debilitating problem as men. There are many potential causes of urinary incontinence in women. Here are some of the most common.

Pregnancy & Childbirth

Healthcare professionals estimate that about 40 percent of all women experience urinary incontinence during pregnancy. During and after childbirth, women are at a high risk of experiencing stress incontinence. This form of incontinence refers to accidental leakage due to sudden pressure on the bladder, with laugh, cough, or exercise.

As babies develop during pregnancy, the uterus expands significantly. This process leads to excess pressure on the bladder and urethra. All it takes is one cough, laugh, or intense physical motion to lose control.

Incontinence in women during pregnancy can also stem from hormonal changes. Fluctuations and the general increase in progesterone levels weaken the pelvic floor. One job of progesterone during pregnancy is to loosen ligaments and joints, making room for the womb. But, the hormone is also capable of weakening the pelvic muscles that impact urine control.

Giving birth can result in urinary incontinence in women that lasts for several weeks. Vaginal delivery, in particular, is known to stretch and weaken the pelvic floor muscles. These muscles act as a sling to support the pelvic organs, including the bladder. When damaged during childbirth, some women might experience pelvic organ prolapse and continued incontinence issues. 

Childbirth may also damage the nerves that communicate with the bladder. Generally, incontinence troubles resolve themselves six weeks or so after delivery. But in some women, they can be the start of lifelong bladder control battles.

• 30% of women will continue to suffer from urinary incontinence as a result of a pregnancy.

RELATED: Urinary incontinence and vaginal prolapse after vaginal delivery

Aging

Urinary incontinence is more common in older women. Roughly 30 percent of all women between the ages of 45 and 64 experience it. For women 65 and older, that figure jumps up to about 50 percent.

Contrary to popular belief, urinary incontinence in women is not a normal part of getting older. It’s a medical condition that’s likely a byproduct of another underlying health concern. For older women, the potential causes of incontinence widen.

In many instances, the culprit is pelvic floor atrophy. The effects of previous pregnancy and childbirth can also come into play. Several neurological disorders, such as Alzheimer’s disease, stroke, and Parkinson’s disease, might be to blame for urinary incontinence in women as well.

Menopause

In addition to hot flashes, night sweats, and mood changes, urinary incontinence is a common complaint during menopause. During this life stage, the body stops producing estrogen and progesterone. Researchers believe that these lower estrogen and progesterone levels weaken the urethra and the pelvic floor muscles.

Less estrogen also makes vaginal tissue less elastic while thinning the lining of the urethra. All of these seemingly minor changes add up. Plus, additional biological changes like weight gain and pelvic organ prolapse can occur after menopause. These events make urinary incontinence in women much more likely during and after menopause.

RELATED: How to Prevent Genital and Urinary Problems During and After Menopause?

Many women will start to experience incontinence during perimenopause when hormonal changes first begin. But, the brunt of bladder control issues happens during menopause and continues long after. Women can experience all forms of urinary incontinence, including frequent stress accidents, sudden urges to urinate, and overactive bladder.

Urinary incontinence in women is far more common than most think. That said, it doesn’t have to affect your life. Problems with bladder control are usually very treatable with the right care.

Dr. Tahery is a urogynecologist in Los Angeles. His gynecology and urology knowledge provides a deeper understanding of urinary incontinence in women and other pelvic floor issues.

Contact Dr. Tahery’s offices in Los Angeles and Glendale today to schedule a consultation and learn more about potential treatment options.

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Contrary to popular belief, pelvic floor dysfunction is not a rare occurrence. Issues can arise at any point during a woman’s life. While these issues usually aren’t life-threatening, they can have a debilitating effect on a woman’s quality of life. There are a few types of disorders. Here are the most common that affect women and their accompanying symptoms.

Urinary Incontinence Symptoms

Urinary incontinence is the most widespread pelvic floor disorder. It results in complete or partial loss of bladder control. When this occurs, the muscles that control the bladder valve weaken. Usually, the issue is that the pelvic floor muscles are unable to relax. Women may experience a loss of muscle coordination, preventing at-will urination and frequent accidents.

At first, symptoms can be as innocent as slight urine loss during a sneeze or cough. However, pelvic floor dysfunction can worsen and cause regular involuntary loss.

Symptoms of urinary incontinence can vary widely from one person to the next. However, they often include:

• A feeling of pressure on the bladder
• Frequent urination
• Difficulty urinating at will
• Accidents when laughing, coughing, or sneezing
• Urine loss or leakage
• Inability to empty bladder completely

RELATED: Urinary Incontinence Specialist in Los Angeles

Pelvic Organ Prolapse Symptoms

Pelvic organ prolapse is one of the more alarming forms of pelvic floor dysfunction. It occurs when the pelvic floor muscles and tissue weaken. The otherwise supportive sling can become thin or tear completely, resulting in the organs “falling” out of place.

Prolapse can cause significant discomfort for women. Not only that, but the standard function of the fallen organs become compromised. The organs can herniate into the vaginal wall, resulting in a visible bulge. It is a cystocele when the bladder herniates and a rectocele when the rectum herniates.

Some of the most common symptoms for this type of pelvic floor disorder include:

• Weighty feeling in the pubic area
• Dragging discomfort in the vagina
• Visible bulges in the vagina
• Pain or discomfort during sex
• Difficulty with urination or bowel movement

RELATED: Organ Prolapse Treatment in Los Angeles

Fecal Incontinence

Fecal incontinence is similar to urinary incontinence. The difference, however, is that this pelvic floor disorder involves a loss of bowel control. The pelvic floor muscles controlling the bowels and rectum do not perform efficiently, resulting in numerous problems.

Women can suffer from passive incontinence, which refers to the sudden passing of stool without any control. Or, they can suffer from urge-related incontinence. This form of pelvic floor dysfunction pertains to constant muscle contraction that prevents the passage of stool.

Fecal incontinence can affect women at any age. However, it’s most common in seniors and women recovering after childbirth. Some common symptoms include:

• Sudden accidents
• Periodic stool or mucus leakage
• Difficulty passing stool
• Chronic constipation
• Frequent bouts of diarrhea

Pelvic floor disorders can negatively impact your day-to-day life. But, they are highly treatable. Dr. Tahery is a practicing urogynecologist in Los Angeles. He can create a custom treatment plan to mitigate these disorders’ effects. Contact us today to schedule your consultation with Dr. Tahery, learn more about pelvic floor dysfunction, and address your symptoms once and for all.

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