pubococcygeus exercises /pyo̅o̅′bōkoksij″ē·əs/ [L, pubes + Gk, kokkyx, cuckoo’s beak; L, exercere, to make strong] , a regimen of isometric exercises in which a woman executes a series of voluntary contractions of the muscles of her pelvic diaphragm and perineum in an effort to increase the contractility of her vaginal introitus or to improve retention of urine. Also called Kegel exercises. ▪ METHOD: The exercise involves the familiar muscular squeezing action that is required to stop the urinary stream while voiding; that action is performed in an intensive, repetitive, and systematic way throughout each day. ▪ INTERVENTIONS: The woman is instructed in how to duplicate the squeezing, pulling-up action. A woman whose muscles are particularly attenuated may have difficulty understanding or feeling the muscular action involved. It is often helpful for her to be told that the action is exactly the same as that required to stop the flow of urine. When the woman can effect the contraction required, she is asked to hold the contraction for 6 to 10 seconds, allowing the muscles to relax completely between contractions. She is then advised to perform 10 to 15 repetitions of the contraction in a series and to repeat the series three to four times each day. She is further advised that the physiological nature of muscular exercise is such that weakened muscles may gain strength during the early phases of an exercise program and that, with diligence, she can expect to notice significant improvement in control that will continue as she maintains the regimen of exercise. ▪ OUTCOME CRITERIA: Laxity and weakness of the pubococcygeus muscles, often a result of childbirth, may predispose certain women to looseness of the vaginal introitus and to stress incontinence. These problems may be ameliorated as the strength and tone of the muscles are increased through exercise. The rapidity with which a woman can, during voiding, close off the urinary stream is taken as a measure of the strength and tone of her pubococcygeus muscles. Ideally she should be able to perform the action completely and almost instantly.
