International Urogynecology Journal

, Volume 19, Issue 6, pp 773–782

Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence

  • Janis M. Miller
  • Carolyn Sampselle
  • James Ashton-Miller
  • Gwi-Ryung Son Hong
  • John O. L. DeLancey
Original Article

DOI: 10.1007/s00192-007-0525-3

Cite this article as:
Miller, J.M., Sampselle, C., Ashton-Miller, J. et al. Int Urogynecol J (2008) 19: 773. doi:10.1007/s00192-007-0525-3

Abstract

The aim of the study was to determine the immediate effect of timing a pelvic muscle contraction with the moment of expected leakage (the Knack maneuver) to preempt cough-related stress incontinence. Women performed a standing stress test using three hard coughs without and then with the Knack maneuver. Volume of urine loss under both conditions was quantified with paper-towel test. Two groups of women were tested: nonpregnant women (n = 64) and pregnant women (n = 29). In nonpregnant women, wetted area decreased from a median (range) of 43.2 (0.2–183.7) cm2 without the Knack maneuver to 6.9 (range of 0 to 183.7 cm2) with it (p < 0.0001); while in pregnant women it decreased from 14.8 (0–169.7) cm2 to 0 (0–96.5) cm2, respectively (p = 0.001). This study confirms the effect from the Knack maneuver as immediate and provides a partial explanation for early response to widely applied pelvic muscle training regimens in women with stress incontinence.

Keywords

Urinary incontinence Pelvic muscle training Stress incontinence Pelvic muscle education Kegel Pregnancy 

Copyright information

© International Urogynecology Journal 2007

Authors and Affiliations

  • Janis M. Miller
    • 1
    • 2
  • Carolyn Sampselle
    • 1
  • James Ashton-Miller
    • 3
  • Gwi-Ryung Son Hong
    • 4
  • John O. L. DeLancey
    • 2
  1. 1.School of NursingUniversity of MichiganAnn ArborUSA
  2. 2.Obstetrics & GynecologyUniversity of MichiganAnn ArborUSA
  3. 3.Mechanical EngineeringUniversity of MichiganAnn ArborUSA
  4. 4.Department of NursingCollege of Medicine, Hanyang UniversitySeoulSouth Korea

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