Critical Evaluation of the Crede Maneuver: A Urodynamic Study of 207 Patients

Abstract

The efficacy of Crede''s maneuver [application of suprapubic pressure] to promote voiding was evaluated prospectively in 207 patients with a variety of lower urinary tract disorders. The normal response to Crede''s maneuver was contraction of the external urethral sphincter (Crede effect), increase in urethral pressure and maintained closure of the vesical neck. Relaxation of the external urethral sphincter and synchronous opening of the bladder neck during Crede''s maneuver were seen in only 4 patients (2%). Crede''s maneuver is an inefficient method of bladder emptying in the majority of patients. When voiding is accomplished with Crede''s maneuver it usually is grossly inefficient and associated with significant urethral obstruction.