Here’s how to do it
Close
Next time you go for a pee, stand or sit and consciously and deliberately don’t let go of the flow. In other words hold it inside you without peeing. While you’re doing this think about which muscles you’re controlling. Think about the messages that your brain is sending to those muscles to tell them ‘stay closed’. And be conscious of how you’re deliberately keeping closed and staying closed.
Relax
Now instruct these muscles to relax. Not by letting go all at once, but by relaxing them slowly and allowing the flow to start gradually. Then allow the flow to increase slightly while deliberately and consciously controlling it.
Then, still under your conscious direction, relax your muscles a little bit more. Then relax them more to allow the flow to pass through fully.
Close
Now actively instruct the same muscles to contract. You can do this in two ways. Either do it in three stages getting progressively tighter each time until the flow slows and stops. Or simply issue the command to the muscles to close and stop the flow. Make them close and stay closed so that the flow stops completely.
Relax
Now gradually open them as before with you completely in control of them again until you have full flow. Then repeat the process of closing them again to stop the flow. Depending on how much urine you have, try to do this at least once every time you pee.
Stop/start
Another way of doing this is to simply stop/start stop/start stop/start during urination, always heightening your awareness of which muscles you’re using to do this. Focus on how you instruct your muscles to stop and start as and when you want them to.
Continue exercising these muscles
Now that you’re aware of which muscles you use to control the start, stop and flow of urine you can actually start to exercise them and strengthen them even when you don’t have any urine to pass.
Make sure you exercise the right muscles
It’s important that you realise that it’s only these muscles that you need to activate during your pelvic floor exercises in order to control your incontinence. Simply squeezing your bum cheeks will exercise the wrong muscles. Squeezing everything in the pelvic floor isn’t going to help your recovery from post operative urinary incontinence in any way. The diagram below shows that there are two groups of muscles controlling this process. One is a sphincter just below the bladder and the other is the pelvic floor itself.
The third sphincter
Men have a third sphincter at the end of the penis which is usually used to control ejaculation. But it’s also very effective in holding back the urine flow. Successful management of urinary continence lies in learning how to control your bladder sphincter and the pelvic floor below it only, and not your whole pelvic floor.
