Credé Maneuver

What is the Credé maneuver?

The Credé (pronounced “cruh-DAY”) maneuver is a technique that helps release urine (pee) from your body when a disease or condition prevents you from peeing. The 19th-century German gynecologist and obstetrician Carl Credé originally developed the maneuver to help deliver the placenta during labor.

The Credé maneuver stimulates the detrusor muscle in your bladder. The detrusor muscle is a collection of smooth muscle fibers that squeeze or spasm to empty pee from your bladder. Sometimes, people can develop conditions that prevent the detrusor muscle from working as it should. The Credé maneuver helps stimulate the detrusor muscle to squeeze or put pressure on your bladder to force pee out.

Another name for the Credé maneuver is suprapubic pressure. “Suprapubic” means above the pelvis bones.

What does the Credé maneuver manage?

The Credé maneuver helps manage urinary retention. Urinary retention has many possible causes. Some include:

• Urinary tract infections (UTIs) that cause swelling and inflammation.
• Damage to the nerves that help control when you pee, such as a spinal cord injury or neurogenic bladder.
• An enlarged prostate (benign prostatic hyperplasia).
• Kidney stones.

Is the Credé maneuver safe?

Long-term use of the Credé maneuver isn’t safe. You shouldn’t use the Credé maneuver as the primary way to empty your bladder if you have a condition that causes urinary retention. You should only use it temporarily until you can empty your bladder through other more efficient methods, such as a Foley catheter. Any time you experience urinary retention, reach out to a healthcare provider.

What happens during the Credé maneuver?

The Credé maneuver typically follows these steps:

• A healthcare provider helps you sit or stand over a toilet or bedpan.
• The provider will put a pair of gloves on their hands. They’ll place their hands over your lower abdomen, below your belly button and above your pubic bone.
• They’ll repeatedly stroke their palms downward or use their fingers to gently poke your bladder through your abdomen. This causes your bladder to empty (void).
• They may also push their palms or fingertips into the area and hold them there to maintain pressure until pee stops flowing out.
• When performing the Credé maneuver on yourself, you may need to lean slightly forward to put extra pressure on your bladder.

Can I perform the Credé maneuver on myself?

Yes, you can perform the Credé maneuver on yourself. But it’s a good idea to first have a healthcare provider show you how to perform it. They should also watch you perform it on yourself to ensure you’re doing it correctly. They can also guide you on how often is too often when it comes to using this technique.

How long does the Credé maneuver take?

The Credé maneuver should take no longer than a few minutes to perform.

What are the benefits of the Credé maneuver?

The primary benefit of the Credé maneuver is that it helps drain your bladder. Not being able to completely drain your bladder can cause complications that include:

• Bladder stones.
• Swollen (distended) bladder.
• Swelling in your kidneys.
• Permanent damage to your bladder or kidneys.

What are the risks or complications of the Credé maneuver?

You shouldn’t use the Credé maneuver while healing from surgery on or around your abdomen or pelvis. It can:

• Cause pain.
• Tear your stitches (sutures).
• Cause bleeding.
• Increase your risk of infection.
• Delay healing.

You also shouldn’t use the Credé maneuver on a child with a neurogenic bladder. It increases their risk of damaging their kidneys (renal rupture).

Using the Credé maneuver may cause vesicoureteral reflux (VUR). VUR is when pee flows back up through your ureters to your kidneys. Your kidneys help filter blood and create pee. Your ureters are muscle-lined tubes that transfer pee from your kidneys to your bladder.

Other possible long-term complications of the Credé maneuver include:

• Bruising.
• Hernia.
• Hemorrhoids.
• Pyuria.
• High bladder pressure.
• Pee backing up into your kidneys (hydronephrosis).
• Stretching your urethra.

What are alternatives to the Credé maneuver?

Credé maneuver alternatives include:

• Foley catheter. A urinary catheter is a medical device that a healthcare provider inserts into your urethra and extends to your bladder. It drains pee into a bag outside of your body.
• Self-catheterization. You insert a temporary urinary catheter through your urethra to your bladder and drain pee into the toilet. Take the catheter out immediately once you finish.
• Medication. Medications can help treat conditions that cause urinary retention. These may include antibiotics to treat UTIs, alpha-blockers to help your prostate muscle relax and medicines that help shrink your prostate.
• Surgery. Surgery can help treat kidney stones (including a ureteroscopy or shockwave lithotripsy), remove part or all of your prostate (prostatectomy), decrease the size of your prostate, or open or widen your urethra (urethral dilation).
• Pelvic floor exercises. Kegel exercises and other pelvic floor therapies can help strengthen the muscles you use to pee. A pelvic floor physical therapist can help teach you pelvic floor exercises.

When should I call a healthcare provider?

Call a healthcare provider anytime you have any trouble peeing or have any pain around your bladder, especially if you haven’t peed in more than six hours and feel pressure in your pelvic area. They can help determine what’s causing your urinary retention.

What is the Valsalva maneuver for urination?

The Valsalva maneuver is a technique that involves pinching your nose, closing your mouth, straining your abdominal muscles, bearing down and breathing out (exhaling) to increase pressure in your chest. It can put downward pressure on your bladder to help you pee. It also helps:

• Unclog your ears.
• Slow your heart rhythm.
• Void your bowels (poop).