Pelvic floor exercise, or Kegel exercise (//, //), consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the "Kegel muscles". Several tools exist to help with these exercises, although various studies debate the relative effectiveness of different tools versus traditional exercises.[1][2] Exercises are usually done to reduce urinary incontinence,[3] reduce urinary incontinence after childbirth,[4] and reduce premature ejaculatory occurrences in men,[5] as well as to increase the size and intensity of erections.[6] They were first described in 1948 by Arnold Kegel.

The aim of Kegel exercises is to improve muscle tone by strengthening the pubococcygeus muscles of the pelvic floor. Kegel is a popular prescribed exercise for pregnant women to prepare the pelvic floor for physiological stresses of the later stages of pregnancy and childbirth. Kegel exercises are said to be good for treating vaginal prolapse[7] and preventing uterine prolapse[8] in women and for treating prostate pain and swelling resulting from benign prostatic hyperplasia (BPH) and prostatitis in men. Kegel exercises may be beneficial in treating urinary incontinence in both men and women.[3] Kegel exercises may also increase sexual gratification, allowing women to complete pompoir and aid in reducing premature ejaculation[5] in men. The many actions performed by Kegel muscles include holding in urine and avoiding defecation. Reproducing this type of muscle action can strengthen the Kegel muscles. The action of slowing or stopping the flow of urine may be used as a test of correct pelvic floor exercise technique [9] but should not be practiced as a regular exercise to avoid urinary retention.

It is now known that the components of levator ani (the pelvic diaphragm), namely pubococcygeus, puborectalis and ileococcygeus, contract and relax as one muscle. Hence, pelvic floor exercises involve the entire levator ani rather than pubococcygeus alone. Pelvic floor exercises may be of benefit in cases of fecal incontinence and pelvic organ prolapse conditions e.g. rectal prolapse.[10]

A pelvic toning device (generically referred to as a Kegel exerciser,[11] pelvic floor toner, pelvic floor muscle toner or pelvic toner) is a medical or pseudo-medical device designed to help women exercise their pelvic floor muscle and improve the muscle tone of the pubococcygeal or vaginal muscle.

The original pelvic toning device was the perineometer, invented by Arnold Kegel to facilitate the measurement of the strength of the pubococcygeus muscle when it was resting and being actively squeezed - sometimes referred to as the Kegel tone.

His device was a combination of rubber balloons and tubes that measured pressure using a column of water. It was neither easy to use nor portable.

During the latter part of the 20th century, a number of medical and pseudo-medical devices were developed and launched onto the market. Some of these are used in a clinical setting, but most are designed for women to use in the privacy of their own home.

Pelvic toning devices fall into a number of different types:

Regular Kegel exercises should achieve tangible results (such as less frequent urine leakage) within about 8 to 12 weeks. For some women, the improvement could be dramatic.[12] Unfortunately there are a number of products on the market that have no impact at all on the pubococcygeus muscle. If the PC muscle is not engaged then it is impossible to improve the muscle tone or strengthen the muscle. Devices that are used externally, for example between the thighs, may exercise the adductor muscle but do nothing for the pelvic floor.

Clinical research published in the British Medical Journal [1] compared pelvic floor exercises, vaginal weights and electro-stimulation in a randomised trial. The research recommended that pelvic floor exercise should be the first choice of treatment for genuine stress incontinence because simple exercises proved to be far more effective than electro-stimulation or vaginal cones.

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Kegel exercise - Wikipedia, the free encyclopedia