@mirsy Surgeons will install the bulb differently. My first one barely extended out, very hard to squeeze. Doc said keep pulling. I had many problems, leaked all the time even though it was activated. Had bulb switched to other side. Nope. Emergency surgery 6 months after installation to remove it all. Urethroplasty and 13 months with suprapubic catheter for it all to heal. Looked like not installed properly with enough slack so when I pulled it pulled on the cuff that eroded the urethra. New surgeon installed it with plenty of slack. I can grab the tubes and hold on for 2 handed or do it 1 handed. Be careful if you pull on the bulb. I believe you should be able to hold on to the tubes and squeeze. If you can't, be careful on pulling. Not too much pain after activation. Works great, but I leak some when sitting on a hard surface, like a chair or stool. Good luck.