Straining or expressing are methods used to empty your bladder that involve increasing the pressure inside your bladder enough so that urine flows out.
How does straining or expressing work?
Straining, also known as the Valsalva manoeuvre, works by physically increasing your abdominal pressure. You do this by holding your breath and bearing down on your abdomen. This increase in pressure may be enough to force urine out of the bladder for some people.
Expressing (also known as Crede) is another method of increasing the pressure inside the bladder. It is achieved by pushing your abdomen over the bladder itself. This action is like squeezing water out of a balloon and can help to empty the bladder for some people.
Straining and expressing are not for every SCI bladder
For patients that can’t perform intermittent catheters, straining or expressing may be preferred over indwelling catheters.
Complications that may occur
For people with high outlet resistance these methods may cause other complications that may not be immediately noticeable:
- Complications of the upper urinary tract
- Hydronephrosis
- Improper emptying (stasis)
- Vesicoureteral reflux
- Hernia, due to excessive abdominal pressure over time.