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PHYSIOLOGIC THERAPY FOR URINARY STRESS INCONTINENCE

Arnold H. Kegel, M.D.
JAMA. 1951;146(10):915-917. doi:10.1001/jama.1951.03670100035008.
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Poor control of the bladder outlet is observed in approximately 5.5% of all adult women.1 To the patient the condition is always embarrassing, often humiliating, and at times incapacitating. In the past patients with more advanced urinary stress incontinence were treated by surgical intervention, with results that were not always satisfactory. But little could be done for the great number of women with slight or moderate complaints. As operation is not indicated in such cases, temporizing procedures had to be applied that all too often resulted in dissatisfaction of patient and physician alike. In the meantime, however, it has been demonstrated that in the overwhelming majority of cases,2 even with a history of childbirth injury, urinary stress incontinence is due to inherent weakness of the muscles surrounding bladder neck and vagina. This condition is amenable to correction through reeducation of muscular function and resistive exercises that can be

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