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  • Writer's pictureJane Franczak

The Pee Symphony

I had a patient come in today who described her technique for training her pelvic floor muscles. She stops the urine flow while she is on the potty so she can improve her pelvic floor strength. She had read about this method in a magazine and her doctor's office encouraged her to practice the technique. What she described is called the "Urine Stop Test." It is only a test, not a training method.

During the normal micturition cycle (urine storage and emptying), the bladder is constantly being filled and storing urine. The bladder muscle, the detrusor, detects the stretch as it fills and monitors the need to empty. The pelvic floor muscles are contracting along with the sphincter to allow for storage.

The 2 sets of muscles work in harmony such that when one is active, the other is relaxed. When the bladder has reached maximum storage capacity, the pelvic floor muscles relax, the detrusor squeezes, and the urine flows out. Once empty, the detrusor stops squeezing, the pelvic floor muscles contract along with the sphincter to close the urethra ( the pee tube) and allow the bladder to begin storing urine again.

Imagine a symphony. The stringed instruments are playing, along with the wind instruments. A beautiful, coordinated piece of music is being played filling the hall with harmony and beauty. Now, picture an electric guitar sends a jolt of loud, disharmonious noise into the room. The music will be disrupted. The musicians will be shocked, to say the least. The song they are playing may stop, slow down or change. It may be hard to recover from the interruption.

When one interrupts the normal emptying cycle of urination or Pee Symphony, by squeezing the pelvic floor when it should be relaxed, the bladder finds it hard to recover. The bladder may know that there is still more to empty, but has to find its groove again. If interrupted too many times, the bladder may learn that it is not necessary to fully empty the bladder. Eventually, The detrusor may stop squeezing after it has emptied only a portion of the contents. This will become the new normal. A person will leave the bathroom without fully emptying and will need to void more often.

Bottom line: the Urine Stop test is only a test. Practice the test only 1x/month. Perform pelvic floor contraction exercises (PFMx) aka Kegels instead. Hold 5-10 seconds, relax 5-10 sec. Repeat 30x/day. Once you are strong enough and have the endurance, hold for 10 seconds, pulsing at the top of the hold 5x, before fully releasing.

See a pelvic floor therapist for more details on how to perform these exercises. Use biofeedback to determine if you are performing them correctly. Use the Urine stop test 1x/month to test your strength.

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