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Research article
First published online March 16, 2009

The 4-3-2 Method for Kegel Exercises


Performing Kegel exercises following prostatectomy is helpful in restoring continence, but requires concentration to accomplish the required contractions consistently. Confusion and effort with executing the procedure can reduce compliance. A new method subdivides the exercises into segments that can be executed without counting. The patient performs four sets of contractions daily, each set consisting of three contractions lasting two natural breaths, separated by two natural breaths. Because each number is below the limit that can be apprehended by subitizing without counting, cognitive effort is minimized.


Kegel, A.H. ( 1951). Physiologic therapy for urinary stress incontinence. Journal of the American Medical Association, 146, 915.
Parekh, A.R., Feng, M.I., Kirages, D., Bremner, H., Kaswick, J., & Aboseif, S. ( 2003). The role of pelvic floor exercises on post-prostatectomy incontinence. The Journal of Urology, 170, 130-133.
Revkin, S.R., Piazza, M., Izard, V., Cohen, L., & Dehaene, S. ( 2008). Does subitizing reflect numerical estimation? Psychological Science, 19, 607-614.
van Kampen, M., de Weerdt, W., Van Poppel, H., de Ridder, D., Feys, H., & Baert, L. ( 2000). Effect of pelvic floor re-education on duration and degree of incontinence after radical prostatectomy: A randomised controlled trial . Lancet, 355, 98-102.

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Article first published online: March 16, 2009
Issue published: March 2010


  1. prostate cancer
  2. Kegel exercises
  3. prostatectomy
  4. pelvic floor exercises

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© The Author(s) 2010.
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Published online: March 16, 2009
Issue published: March 2010
PubMed: 19477754



Bruce Bridgeman, PhD
Psychology Department, University of California, Santa Cruz, [email protected]
Steven G. Roberts, MD
Palo Alto Medical Foundation, Palo Alto, California

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