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Kegeling: First Line of Defense

Kegeling: First Line of Defense

In an effort to heal and strengthen my pelvic floor, and eliminate the incontinence that followed my radical laparoscopic prostatectomy in April 2018, I started seeing a physical therapist, Dr. Peter Muhn, at USC in September. I’d already been kegeling for several months and I was seeing a lot of improvement, but I felt I’d plateaued, and I wanted to pursue this new opportunity to help myself recover.

Reassurance from my doctor

During my first visit I shared my prostate cancer journey with Dr. Muhn, I let him know the progress I’d made with reducing incontinence, and that my goal was to eliminate it if possible, the sooner the better. He assured me that my progress was normal, that time and effort would produce the result I was hoping for, but that patience and persistence were important, that a year of healing and strengthening was not unusual. Dr. Muhn and his assistant observed my kegeling technique and then gave me a set of revised exercises to do between visits.

Dissatisfied with my progress

WebMD offers this short definition of kegeling and its benefits for men: “Kegels are exercises that help you zero in on and strengthen muscles below the bladder that help control urination. In men, urinary incontinence can be caused by a weak urinary sphincter that may result from surgery for prostate cancer, an overactive bladder, or a bladder that doesn’t contract.” My new exercises consisted of short bursts of contractions, longer holds of up to 10 seconds, and a variety of positions: lying down, sitting, standing.

I followed Dr. Muhn’s instructions, experienced some improvement, and then returned for another visit in late October. I expressed that I wasn’t fully satisfied with my progress, explaining that while at rest or just doing light activities around the house my leakage was minimal, but long walks and vigorous exercise resulted in soaking a light shield. To play golf and walk the course I had to wear a maximum absorbency guard and change it after nine holes. I had to take the same precaution for rock climbing or back country hikes. In other words, I was constantly aware of my incontinence while doing the activities I enjoy most.

Measuring pelvic floor strength

To better test my pelvic floor strength and the power of my kegels, Dr. Muhn asked if I would agree to having them measured graphically through use of a rectal sensor. He explained the process, showed me the device, and I agreed. The sensor was inserted into my rectum, attached to a computer, and then I went through a series of kegel exercises that were visible as graphs on the computer screen: a bar graph, a pyramid graph, a peaks and valleys graph, etc. The graphs showed how strong my contractions were, how long I could hold them at a given level, and how much control I had. The computer recorded the information. I found that my hold during most ten second contractions began to weaken at five seconds.

Forging ahead with optimism

I now have a visible and numerical baseline to work with. We made a couple of changes in my exercise routine, and since my return home I’ve been working to gain pelvic floor strength with a renewed passion. I confess that there are days when I get frustrated when I don’t feel like I’m getting the results I want. I get fatigued by the effort, and I don’t want to do anything. After all, I’ve been kegeling for seven months! But I have to remain committed to give this approach every chance to be successful. My next appointment is in mid-December, a few days after my wife retires. What a nice gift it would be for both of us if my efforts pay off!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • BobB
    9 months ago

    Try staying away from diuretics, coffee, tea and such. I did for nearly 4 months and it was a great help regaining control. Got control back in 6 weeks kegeling, but just chose to stay away from coffee for extended time.

  • TomC.
    9 months ago

    All I got from my urologist were some very simple instructions about kegeling, which I don’t feel are very effective. I’m on the same path as this author, fairly good at night and in the morning but less and less control as the day progresses. I can tell when my muscle contractions are more or less effective – better lying down or sitting but not much good while standing up or moving around. Sometimes just getting out of a chair is enough to lose control. know someone who was so depressed by this loss of control that it changed his whole personality and he became sort of sour and a shut in.
    I have an appointment with my urologist and I think I will ask about physical therapy.

  • Will Jones moderator author
    9 months ago

    Hi @tomc, I have recently heard stories like the one about your friend. I think it’s important to take the long view on this, recognize small gains and keep looking for new resources. I applaud your plan to talk to your urologist about physical therapy and I hope you find someone who specializes in pelvic floor recovery in your area. Just yesterday my wife and I went on a long hike and one shield was all I needed for the day. Little by little, kegeling and natural healing will pay off. Will Jones Moderator

  • ninaw moderator
    9 months ago

    Hi @TomC, as Will describes, it sounds like there’s somewhat of an art to Kegeling correctly. We’ve heard from some Facebook members that sound like they’re on the same path as your friend, and it’s hard to watch. I hate to think that there aren’t options, and I’m glad you haven’t given up on possibilities for improvement. I wanted to also share Erin’s articles, as she’s a pelvic floor therapist: Wishing you luck with the conversation and if you can, let us know how it goes. – Nina, Team

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