Once you’ve worked out which muscles you use when you want to pee, or when you have to hold it back because there’s no convenient bathroom nearby and you simply have to hold it inside you, you can now start exercising these muscles.
It’s important that you exercise these muscles, and these muscles only. They are the ones towards the front of your body and not the ones towards the back. They are those muscles above the line of the superficial transverse perineal muscle and not below it. Here’s the diagram again.
Don’t be a quitter
If you look online you’ll find a lot of controversy about doing these exercises and many people fail to get it right and give up. Generally women have more difficulty than men in getting it right. One of the reasons for this is that they have a large area of the front part of the pelvic floor containing a hole (the vagina). This makes it difficult for them to squeeze closed as well as men can – men’s muscles on either side of the midline are fused together which makes it easier to squeeze them closed.
Also in men, overlying the pelvic floor muscles is the base of the penis. This gives this area extra strength. Also men use these muscles regularly when having sex. So they tend to develop better control of the pelvic floor than women.
They are difficult – but never give up!
Nevertheless, whether a man or a woman is performing these exercises they are difficult and you are in effect learning a new skill. So if you can’t stop your pee in mid-flow immediately, never…………… I repeat ………. never, never, never give up!
Many people can’t actually stop their urine in mid-flow. Many people can’t work out which muscles they need to use to consciously control this function. So you are not alone if you can’t get it right first try.
Like any skill, it takes time and patience and perseverance to consciously master this function and control it yourself. So it’s worth putting in the effort and getting your control of these muscles to an optimal level before surgery. Because believe me, you’re going to need this skill after surgery.
Now that you’re aware of which muscles you use to pee here are four steps to some simple but very effective pelvic floor exercises:
1. Have a pee and empty yourself of any urine.
2. Go and sit comfortably afterwards, and imagine which muscles you would be using to stop yourself from peeing.
3. Slowly contract those muscles, and only those muscles, consciously controlling them as you do so.
4. Now slowly relax them under your conscious control,
5. Repeat this slow contraction and relaxation 10 times in a row.
6. Now relax
7. Give yourself a rest and repeat the exercise for as long as you feel comfortable.
8. Try and do this as often as you can during the day.
Do them whenever wherever
Do this as often as you can whether it is while sitting at your desk or sitting in a traffic jam. There are lots of opportunities during the day to do this routine. And nobody will even be aware that you’re doing it.
Make sure you exercise the right muscles
Remember also never, ever to tense your buttocks, your abdomen or your leg muscles while you’re doing your pelvic floor exercises. If you do all these muscles will be exercised and this won’t help to control your flow.
You need to exercise the muscles above the line in the diagram above (towards the front of your pelvic floor) and only these muscles. The rest of your body should remain completely relaxed.
This is essentially the same as step 1, but instead of sitting comfortably you stand with your legs parted and do the same exercises. This is more difficult. When you’re standing up, all your body weight is supported by your pelvic floor. So squeezing and relaxing the right muscles is a lot more difficult to coordinate under your conscious direction than when sitting down.
When you’ve got the hang of this you can vary the exercises. Instead of repeating squeeze/relax, squeeze/relax, etc try and squeeze and hold it for five seconds. Then relax for five seconds. Keep doing this for about 20 seconds or even more if you like. This helps increase your awareness of which are the right muscles to activate to control incontinence. But it also increases their strength enormously.
Now either squat or sit on a very low stool (no more than 20 cm high) or the bottom step of a flight of stairs. Part your legs so that your knees are as far apart as possible, and as close to your chest as possible. Your pelvic area is now not supported.
Do the exercises described in step 1 and 2. Make sure that the muscles only open and close under your active conscious control. Never let them open and close automatically.
This step puts maximum strain on your pelvic floor muscles and so builds up their strength and power. And your ability to control them to their maximum potential.
Now try to do some of these exercises before emptying your bladder.