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Valsalva Maneuver

The Valsalva maneuver is an exercise used to assist in the emptying of the bladder and sometimes, within the context of sexual therapy, to assist in the treatment of the common male sexual problem of premature or rapid ejaculation.

It is a relatively simple technique, which in both conditions involves holding the breath while bearing down as if to have a bowel movement. In cases of the inability to fully empty the bladder, known as flaccid bladder, the Valsalva maneuver is initiated at the end of urination. While seated on the toilet, the subject, feeling he has finished urinating, holds his breath, leans forward slightly, and bears down as if to have a bowel movement. This procedure is helpful in emptying the bladder more completely. The Valsalva maneuver is one of several methods commonly prescribed for people with Multiple Sclerosis, a disease that effects sensory and motor control that often includes flaccid bladder among its complications.

In the treatment of the sexual problem of rapid or premature ejaculation the maneuver is applied differently. While a broader goal of couples sexual therapy for any disorder is to increase communication and tolerance for intimacy between partners, a specific goal in the treatment of rapid ejaculation is the male increasing his sense of ejaculatory control. The Valsalva maneuver can be used in the context of therapy along with the Semans start-stop technique to delay the ejaculatory response. After a man has learned to talk openly about his anxieties and fears of sexual performance with his partner and has practiced the start-stop technique, he might be introduced to a version of the Valsalva maneuver to assist him in attaining a greater sense of ejaculatory control. When he feels he is about to ejaculate as he approaches the point of "no return", known as ejaculatory inevitability, he holds his breath and bears down as if trying to have a bowel movement. Some therapists have found that their patients report the maneuver has helped them to achieve better ejaculatory control.

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