A vaginal cone (or vaginal weight) is a medical device specifically designed and shaped to exercise pelvic floor muscles in order to strengthen them and restore proper bladder functions in women with urinary stress incontinence.
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Background
Vaginal cones (also called vaginal weights) as a pelvic floor re-education method have existed for about a quarter of a century. They were developed by Plevnik et al., whose studies have shown that women were able to strengthen their pelvic floor muscles and improve bladder control. Research has shown that biofeedback can improve the efficacy of pelvic floor exercises and help restore proper bladder functions.
Mode of action of vaginal cones
The mode of action of vaginal cones involves a biological biofeedback mechanism. Studies have shown that biofeedback obtained with vaginal cones is as effective as biofeedback induced through physiotherapy electrostimulation.
In the case of pelvic floor exercise - also called perineal re-education - with vaginal cones, the biofeedback mechanism occurs upon insertion of the cone in the vagina, when the targeted pelvic muscles contract around the cone to retain it. This reflex contraction is called passive contraction, as opposed to an active or voluntary contraction performed by the person doing the exercises.
The use of vaginal cones
Vaginal cones are generally used by women experiencing urinary stress incontinence caused by a pelvic floor weakening, or, for example, following abdominal surgery or childbirth. Vaginal cones are generally presented in a case containing a set of small cones of identical shape and volume, but of different weights.
Pelvic floor exercise with vaginal cones
The objective of this exercise method, which is performed at home, is to gradually strengthen the pelvic floor muscles by inserting a cone and retaining it in the vagina as long as possible throughout the exercise session (generally around 15 minutes, once or twice a day). Depending on the level of pelvic muscle weakness, the pelvic floor may not be able to retain the cone with only a passive contraction. Therefore, a voluntary or active contraction – more or less slight as the case may be, will be needed to retain the cone throughout the exercise session. This combination of active and passive contractions ensures a coordinated effort of the weakened pelvic floor muscles and increases the efficacy of the exercise, which should be performed in a standing position and walking around the house.
As long as an active contraction effort is necessary to retain the cone, the exercise should be carried out with the same cone during several exercise sessions, to allow the pelvic muscles to progressively regain their tonus. Once the pelvic floor is able to retain the cone with no active contraction effort, the exercise should be pursued with the next heavier cone, and so on, until the pelvic muscles have regained their strength and are able to properly control the bladder functions. Improvement in pelvic floor muscle tone will be noticeable after six weeks of regular exercise with vaginal cones. Within approximately three months, stress incontinence episodes should become gradually less frequent and eventually stop. The pelvic floor muscles should have gained enough strength and tonus to allow adequate control of the bladder functions.