Urotherapy Book

42 The EMG-uroflow shows that she has trouble in relaxing the pelvic floor when she pees. This time she voids 250 ml with a staccato shape curve and has about 30 ml residual urine after. She didn’t feel that the stream was uneven or that she contracted the pelvic floor. This examination must be repeated in order to have certain diagnosis. Doing an EMG uroflow for the first time could in itself trigger pelvic floor tension as the patient feel a bit uneasy voiding under strange circumstances. Then she is asked if she wants to try to play a video game with the pelvic floor. She agrees to this and plays the biofeedback game on the computer for a few minutes. By contracting and relaxing the pelvic floor, she is controlling a fish catching bubbles in a 5 second contraction and 5 seconds relaxation. She can do this but gets tired quickly and starts to help by contracting the gluteus muscles. The game is then stopped. To promote good micturation habits, she is instructed to:  Go to the toilet and pee 3 hourly during daytime. First time in the morning and last time before going to bed.  Drinking should be done spread out through the day with at least 6-8 glasses of water based drinks.  She is to focus on trying to relax the pelvic floor when peeing and listen to the urine stream. If it loses power, she shall take a deep breath and exhale slowly with semiclosed mouth in order to relax the pelvic floor optimally. She should also relax the gluteus muscles, abdomen and thighs during voiding.