Critical evaluation of the Credé maneuver: a urodynamic study of 207 patients.

The efficacy of Credé's maneuver to promote voiding was evaluated prospectively in 207 patients with a variety of lower urinary tract disorders. The normal response to Credé's maneuver was a contraction of the external urethral sphincter (the Credé effect), an 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 Credé's maneuver were seen in only 4 patients (2 per cent). We conclude that Credé's maneuver is an inefficient method of bladder emptying in the majority of patients and even when voiding is accomplished with Credé's maneuver it usually is grossly inefficient and associated with significant urethral obstruction.