Introduction

This information is for people who have stress incontinence. It tells you about vaginal cones, a treatment used for stress incontinence. It is based on the best and most up-to-date research.

Do they work?

Yes. Vaginal cones are likely to help you strengthen your pelvic floor muscles and stop leaking urine.

But they don't work any better than pelvic floor exercises.

What are they?

Vaginal cones help you do pelvic floor exercises (also called Kegel exercises). Your pelvic floor muscles help to hold your bladder and the tube that carries urine from your bladder to the outside (your urethra) in place. When the muscles get weak, it is hard to stop urine from leaking out.

Vaginal cones are small, plastic, cone-shaped objects that you hold inside your vagina. They usually come as a set of five cones that increase in weight from 20 grams to 100 grams (from 0.7 ounces to 3.6 ounces). The cones are all the same size and have a string on the end to help you take them out.

You can't get vaginal cones on prescription, although you may be able to borrow a set from the local continence clinic. Otherwise you can buy or order them yourself from a pharmacy. One common brand, called Aquaflex, costs about £25.

It's best to talk to your nurse or physiotherapist before using cones. You need to know how to use the cones properly and how to do the exercises.

You start by putting the lightest cone into your vagina with the larger end up. If you can hold this inside for a minute, you then move on to the next cone. When you find the cone that you can hold for just about a minute, that's the one you start with.

You need to hold the cone in your vagina for 15 minutes, twice a day. When you can do this, you move on to the next heaviest cone.

Vaginal cones aren't for everyone. Some women find it hard to use the cones for physical reasons, and other women find them unpleasant to use.

How can they help?

If you use vaginal cones, you might leak urine less often than if you have no treatment. But only about 1 in 13 women say their leaking stops completely. ^[38]

Vaginal cones don't seem to work any better than pelvic floor exercises. ^[38]

How do they work?

If you have stress incontinence, the muscles (including your pelvic floor muscles) that support your bladder neck and keep it closed are weak. When there's extra pressure on your bladder and these muscles (for example, when you cough or sneeze), your bladder neck can't stay closed. So drops of urine leak out of the tube that carries urine from your bladder to the outside (your urethra).

Vaginal cones help you strengthen your pelvic floor muscles. The cones help you tighten (contract) these muscles because if you feel the cone slipping out, you have to tighten them to keep the cone in place. So using cones makes these muscles stronger.