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Recently having a conversation with my mother-in-law and four sisters-in-laws, the subject of Kegel exercise was brought up.

I stated that one of the recommended ways to start strengthening your pelvic floor is to halt your urination for a few seconds and then continue. The five of them told me that it leads to increased in UTIs. They all claimed to have been told this by their respective gynaecologists.

However, after researching this myself, the only thing I found was this article which states that you should try it, but:

However, you should use this method for learning purposes only. It is not a good idea to start and stop your urine regularly, or to frequently do Kegel exercises when you have a full bladder. Incomplete emptying of the bladder can raise your risk for a urinary tract infection (UTI).

Web MD, and other medical sites, all state that holding a full bladder for a long time may cause a UTI, but since you're just stopping the flow for a few seconds, and then continuing to empty your bladder, I don't see the issue.

Oddthinking
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Himarm
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  • i didnt ask for specifics, but it seemed to be a womens health issue in their minds, not a male issue. so anything found on women would be helpful. – Himarm Jan 05 '15 at 19:01
  • I don't know about UTIs, but over-strengthening your pelvic floor muscles can lead to pelvic pain and cramping as well as the urge to urinate more frequently than is required. That could be a source for confusion perhaps – Yamikuronue Jan 06 '15 at 17:10

2 Answers2

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Urinary retention is the inability to voluntarily urinate and complications include infection and renal failure per Brian A Selius in 2008.

Claim #1: One of the recommended ways to start strengthening your pelvic floor is to halt your urination for a few seconds and then continue.

This claim is false since UK NHS cautions

It is not recommended that you regularly stop your flow of urine midstream, because it can be harmful to the bladder.

NHS also states for patients with NMO,

The most important factor is reducing the accumulation of urine, which can build up and stagnate. The risk of a bladder infection is greatly increased with this stagnating urine. A bladder infection can subtly raise the body’s core temperature (a normal response to infection).

Claim #2: Incomplete emptying of the bladder can raise your risk for a urinary tract infection (UTI).

This claim is partly true when the incomplete emptying of the bladder is left untreated with reference to research by Naoki Yoshimura et.al. in 2004.

When the bladder cannot contract properly, some or all of the urine remains in the bladder. If left untreated, this condition can lead to urinary tract infection and damage to the kidneys.

Per Dr.Shobhana Mohandas for urinary problems,

Do not routinely attempt to stop midstream while passing urine, as this may prevent complete emptying of the bladder and lead to infection.

Per Patrick J. Shenot, MD,

Because the bladder stays relatively full, people may sometimes have leakage of urine (overflow incontinence), urinating at night (nocturia), or frequent urination. Because the retained urine can be a breeding ground for bacteria, people may develop a urinary tract infection.

pericles316
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  • I don't think the question makes the claim that the NHS recommends stopping flow midstream. It makes the claim that there are people who recommend it and that happens to be true. The real question is whether that's good advice. The fact that the NHS & Mohandas advices against the practice suggests that's bad advice but neither the NHS nor Mohandas cite studies to prove their claim. I think your answer would be improved if it would cite studies investigating that claim. – Christian Sep 29 '15 at 17:32
  • @Christian-Added additional references to Patrick J. Shenot and NMO-NHS. Also recurrent urinary tract infections is one of the symptoms associated with urinary retention-http://onlinelibrary.wiley.com/doi/10.1002/tre.110/pdf – pericles316 Oct 01 '15 at 03:57
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    I don't see how any of the references provides evidence that regularly doing the exercise of stopping and then continuing urinating mid-flow leads to incomplete emptying of the bladder and an inability to voluntarily urinate. – Christian Oct 01 '15 at 07:03
  • @Christian-regularly stopping and continuing urinating may lead to incomplete emptying of the bladder. Incomplete emptying of the bladder a.k.a. full bladder with retained urine (breeding ground for bacteria) may lead to urinary tract infection. There is no exact research evidence to confirm this process however practitioners recommend us not to regularly stop flow of urine midstream because it can be harmful to the bladder both by incomplete emptying and retaining urine might lead to UTI. – pericles316 Oct 01 '15 at 07:20
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    If you think there no empiric evidence but only argument by authority to back up the advice of not doing the exercise, your answer should say so. Given that the question already cites WebMD I additional think that this answer doesn't fulfill the criteria of skeptics whereby you should bring stronger evidence. – Christian Oct 01 '15 at 07:28
  • The required evidence is already provided per Naoki Yoshimura and several other researchers. Kindly go through Differential Diagnosis and Treatment of Impaired Bladder Emptying paper – pericles316 Oct 01 '15 at 07:38
  • The Yoshimura paper is about patients who can't fully empty their bladder "But what if your patients have the opposite problem—a bladder that “won’t go”? How do you evaluate the patient whose bladder does not empty? What are the most common and effective forms of therapy for impaired bladder emptying?". I don't see a mention in it about people stopping urinating midstream and then continuing for the purposes of kegel training. – Christian Oct 01 '15 at 08:24
  • Let us [continue this discussion in chat](http://chat.stackexchange.com/rooms/29751/discussion-between-pericles316-and-christian). – pericles316 Oct 01 '15 at 08:29
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Most sources consider it a helpful exercise for continence (and possibly potency):

http://www.mayoclinic.org/healthy-living/mens-health/in-depth/kegel-exercises-for-men/art-20045074

http://www.simonfoundation.org/About_Incontinence_Treatment_Options_Kegels_for_Men.html

http://urology.ucla.edu/body.cfm?id=524

http://www.webmd.com/urinary-incontinence-oab/kegel-exercises-treating-male-urinary-incontinence

http://www.urologyteam.com/male-urology/kegel-exercises

I can't find a reputable source that considers it harmful.

CDichter
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    Welcome to Skeptics. Would you mind quoting what you consider the relevant parts of those studies to the answer? Will prevent link rot and many folks will be able to glean relevance better. – JasonR Jan 05 '15 at 18:25
  • [Welcome to Skeptics!](http://meta.skeptics.stackexchange.com/questions/1505/welcome-to-new-users) From what I have seen, these references do NOT support your claims - they side with the OP's family. – Oddthinking Jan 05 '15 at 23:57
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    Reference #1 (Mayo clinic) recommends doing Kegel exercises with an EMPTY bladder. Reference #2 (Simon foundation) warns "do not practice the exercises by slowing down or stopping your urine flow." Reference #3 (UCLA) says "you can exercise them even when you do not have to urinate", without taking a stance on the harms. – Oddthinking Jan 06 '15 at 00:00