Kegel Nation

Name: Kegel Nation
Author: University of California, San Francisco

University of California, San Francisco

DOCUMENTED

Published in academic literature

For:General Public & EnthusiastsPatients & Caregivers

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App Summary

Kegel Nation is a biofeedback and tracking tool designed for men and women, including post-operative transgender patients, to guide pelvic floor muscle training and log urinary symptoms. The app's design is based on the principle that the duration of both contraction and active relaxation are essential parameters for effective pelvic floor muscle training. By allowing users to graph their exercise performance and urinary function data, the tool aims to help patients and clinicians monitor progress and determine response to treatment.

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Detailed Description

Functionality & Mechanism

Developed by urology faculty at the University of California San Francisco (UCSF), Kegel Nation facilitates pelvic floor muscle training for men and women. Its core mechanism is a biofeedback feature designed to measure the duration of muscle contraction and relaxation phases during exercises. The system also captures longitudinal data on exercise frequency, urinary urgency, incontinence events, and pad usage. An integrated graphing function allows for visualization of these trends, intended for user self-monitoring or to support clinical consultation.

Evidence & Research Context

The app's design and clinical rationale are detailed in a research publication, with a specific focus on supporting pelvic floor muscle training and neovaginal self-care in post-operative transgender patients.
The system's biofeedback mechanism is engineered to provide objective data on the duration of pelvic floor muscle contraction and active relaxation, which are essential parameters of effective training.
A preliminary evaluation (N=10) with non-medical users assessed the app's time-recording accuracy against a stopwatch and gathered initial subjective feedback on ease of use and perceived utility.
Its longitudinal tracking of urinary function is intended to assist clinicians and patients in monitoring progress and response to therapy over time.

Intended Use & Scope

This tool is intended for the general public, including men, women, and post-operative transgender individuals, as an adjunct to pelvic floor muscle therapy. It functions as a self-monitoring system to track exercise performance and urinary symptoms. The app does not provide medical diagnoses or substitute for professional medical evaluation, personalized physical therapy, or a prescribed treatment plan.

Studies & Publications

2 publications

Peer-reviewed research associated with this app.

Non-Evaluative Reference

Rating of Pelvic Floor Muscle Training Mobile Applications for Treatment of Urinary Incontinence in Women

Ho et al. (2020) · Urology

Most apps lacked evidence-based content; only one had been clinically tested for effectiveness.

OBJECTIVE To identify pelvic floor muscle therapy mobile health applications (apps) targeting women with urinary incontinence (UI), and evaluate them in a standardized fashion. METHODS A systematic search of English language apps on the Canadian App Store (iOS) and Google Play (Android) Store was performed. Eligible apps were evaluated independently by 5 reviewers using the validated Mobile App Rating Scale (MARS) tool. Descriptive characteristics were summarized and MARS subscale and overall quality scores werereported. RESULTS Of 139 mobile health apps identified, 20 unique apps were included for full review, of which there were 7 iOS only apps, 6 Android only apps, and 7 apps available in both stores. At the time of analysis, most apps had been updated within the last year (60%). Only 1 app had been trialed and verified by evidence in scientific literature. The majority of apps were free to download (80%). The median (interquartile range) MARS overall quality score was 3.7 (0.8) on a 0-5 scale, ranging from 2.7 to 4.1. The highest-rated subscale was "functionality" with a median score of 4.1 (0.6); the lowest-rated was "information" with a median score of 3.4 (0.6). The median MARS subjective quality score was 2.9 (1.0). CONCLUSION There are both free and paid apps available on-line that deliver pelvic floor muscle therapy programs. Evaluation using the MARS tool identified that many apps are not of high quality, and only 1 was evidence-based and has been trialed clinically. This knowledge is relevant to the choice of apps by both patients and caregivers.

Development/Design Paper

Design and Early Clinical Experience with a Smartphone-Based Biofeedback App to Improve Pelvic Floor Muscle Training (Kegel Exercises) and Routine Neovagina Self-Care after Transgender Gender Affirming Surgery

Garcia et al. (2017) · The Journal of Sexual Medicine

Describes the research-driven development of this app

Objectives Frequency and regularity of self-dilation/douching are important drivers of outcomes after vaginoplasty. After vaginoplasty, failure to dilate regularly invariably results in vaginal stenosis. Similarly, failure to relax the pelvic floor muscles (PFM) after FtoM genital surgery contributes to LUTS, urinary retention, and post-op complications. The essential parameters of Kegel (pelvic floor muscle relaxation) exercises are duration of contraction and active relaxation, and, frequency of exercises. We hypothesized that a smartphone-based App that provides users biofeedback re. mean duration of Kegel contraction/relaxation, and which tracks frequency of required neovaginal dilation/douching, could be helpful to transgender patients post-GAS. Materials and Methods We developed an iOS App (TRANS PELVIC HEALTH) to allow natal and transgender men/women to record the duration of active contraction/relaxation, and, urinary frequency, urgency, voiding, leakage events, and, each dilation and douching event--on a daily basis. A study version contains a 12-Q VAS-questionnaire that queries satisfaction (urinary, sexual, erectile), pain control, depression, sleep quality, and quality of life. Data from the App is "pushed" automatically to a custom-database on a secure server. We provided the App to 10 non-medical colleagues (5 women/5 men age 40-70) for evaluation. All completed 10 mock Kegel exercises and used the App to measure contraction/relaxation duration, which was also timed using a stopwatch and compared to duration recorded in our database. We queried users': 1. Reported use ease, 2. Privacy-anxiety; and 3. Perceived usefulness of the App (for Kegel exercises and for post-op care.

In the Media

Pelvic floor muscle training app provides biofeedback

University of California, San Francisco researchers Maurice Garcia, MD, and Peter Carroll, MD, developed Kegel Nation to provide real-time biofeedback for patients performing pelvic floor muscle training, addressing the limitation that "assessment of the duration of contraction is only feasible with in-office biofeedback." An initial validation study in 10 non-medical subjects confirmed the app's accuracy for recording muscle contraction and relaxation duration during Kegel exercises, with very positive participant feedback. The app is now available on iTunes with Android availability coming soon.

UrologytimesRead article

UCSF Urologists Develop Kegel App

UCSF urologists Maurice Garcia and Peter Carroll developed Kegel Nation to help monitor the frequency, progress and quality of Kegel exercise regimens in both men and women, incorporating unique features like touch-screen measurement of pelvic muscle contractions. The app allows patients to measure contraction and relaxation duration by touching the phone's screen during each exercise phase, then archives and charts the measured times with timestamps. A key feature enables wireless connection to a secure server database, allowing physicians to monitor patient progress and provide customized feedback.

UcsfRead article