I do not know whether it is advisable to do this, which is why I was asking others, but I kind of just push down and in on the pouch against the back of the body, like you'd squeeze a tube of toothpaste, but repeatedly until emptied. I use that in combination with internal muscles, lightly bearing down, but only when called for, not constantly. I have to say it again: I don't know if this is recommended. I do know that it feels better to me to empty the pouch as completely as possible.