What is the role of vaginal cones in urinary incontinence treatment?

Updated: Jan 22, 2021
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Vaginal cones are weighted devices designed to increase the strength of the pelvic floor muscles. The cones are available in sets of 5, with identical shape and volume but increasing weights (ie, 20 g, 32.5 g, 45 g, 60 g, 75 g). As part of a progressive resistive exercise program, a single cone is inserted into the vagina and held in place by tightening the levator ani muscles for as long as 15 minutes. As the levator ani muscles become stronger, the exercise duration may be increased to 30 minutes.

This exercise is performed twice daily. The intravaginal weight provides the sensory feedback for the desired pelvic muscle contraction. The sustained contraction required to retain the weight within the vagina increases the strength of the pelvic floor muscles. The best results are achieved when standard pelvic muscle exercises (ie, Kegel exercises) are performed with intravaginal weights.

In premenopausal women with stress incontinence, the subjective cure or improved continence status is approximately 70-80% after 4-6 weeks of treatment. Vaginal cones also may be useful for postmenopausal women with stress incontinence; however, the cones are not effective in the treatment of pelvic organ prolapse.

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