Investig Clin Urol.  2019 May;60(3):142-147. 10.4111/icu.2019.60.3.142.

A current perspective on post-micturition dribble in males

Affiliations
  • 1Department of Urology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 2Department of Urology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. rheewk@hanmail.net

Abstract

Post-micturition dribble (PMD) is the involuntary loss of urine immediately after urination. It is classified as a post-micturition symptom and is more common in males. Traditionally, PMD has been considered to be part of the aging process, to have a low prevalence, and to be less bothersome than other lower urinary tract symptoms (LUTS). However, recent evidence suggests that PMD is not less common and does not elicit less discomfort compared with other LUTS in males. Also, PMD seems to commonly overlap with other LUTS and to be associated with erectile dysfunction. Although the etiology of PMD is not fully understood, a weakness or failure of the pelvic floor muscles is considered to be the most important factor. Although bulbar urethral massage and pelvic floor exercises are known to be effective in treating PMD, pharmacologic treatment has not yet been introduced. Recently, the possibility of treating PMD with phosphodiesterase-5 inhibitor has been suggested.

Keyword

Erectile dysfunction; Lower urinary tract symptoms; Men; Phosphodiesterase 5 Inhibitors; Post-micturition dribble

MeSH Terms

Aging
Cyclic Nucleotide Phosphodiesterases, Type 5
Erectile Dysfunction
Exercise
Humans
Lower Urinary Tract Symptoms
Male*
Massage
Muscles
Pelvic Floor
Phosphodiesterase 5 Inhibitors
Prevalence
Urination
Cyclic Nucleotide Phosphodiesterases, Type 5
Phosphodiesterase 5 Inhibitors

Reference

1. Dorey G. Are erectile and ejaculatory dysfunction associated with postmicturition dribble? Urol Nurs. 2003; 23:42–45.
2. De Nunzio C, Roehrborn CG, Andersson KE, McVary KT. Erectile dysfunction and lower urinary tract symptoms. Eur Urol Focus. 2017; 3:352–363.
Article
3. Sexton CC, Coyne KS, Kopp ZS, Irwin DE, Milsom I, Aiyer LP, et al. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int. 2009; 103:Suppl 3. 12–23.
Article
4. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50:1306–1314. discussion 1314-5.
Article
5. Yang DY, Ko K, Lee SH, Cho JS, Lee SK, Shin TY, et al. Post-micturition dribble is associated with erectile dysfunction in middle-aged and older men with lower uUrinary tract symptoms. World J Mens Health. 2018; 36:263–270.
6. Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C, Ewings P. Pelvic floor exercises for treating post-micturition dribble in men with erectile dysfunction: a randomized controlled trial. Urol Nurs. 2004; 24:490–497. 512
7. Dorey G. Prevalence, aetiology and treatment of post-micturition dribble in men: literature review. Physiotherapy. 2002; 88:225–234.
8. Ko K, Lee WK, Cho ST, Lee YG, Shin TY, Choo MS, et al. Effect of udenafil administration on postmicturition dribbling in men: a prospective, multicenter, double-blind, placebocontrolled, randomized clinical study. Aging Male. 2019; 01. 16. DOI: 10.1080/13685538.2018.1545834. [Epub].
Article
9. Maserejian NN, Kupelian V, McVary KT, Doshi M, Link CL, McKinlay JB. Prevalence of post-micturition symptoms in association with lower urinary tract symptoms and health-related quality of life in men and women. BJU Int. 2011; 108:1452–1458.
Article
10. Pöyhönen A, Auvinen A, Koskimäki J, Hakama M, Tammela TL, Häkkinen JT. Prevalence and bother of postmicturition dribble in Finnish men aged 30-80 years: Tampere Ageing Male Urologic Study (TAMUS). Scand J Urol Nephrol. 2012; 46:418–423.
Article
11. Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009; 104:352–360.
Article
12. Agarwal A, Eryuzlu LN, Cartwright R, Thorlund K, Tammela TL, Guyatt GH, et al. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014; 65:1211–1217.
Article
13. Pöyhönen A, Auvinen A, Häkkinen JT, Koskimäki J, Tammela TL. Population-level and individual-level bother of lower urinary tract symptoms among 30- to 80-year-old men. Urology. 2016; 95:164–170.
Article
14. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. Standardisation Sub-Committee of the International Continence Society. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61:37–49.
Article
15. Hald T, Nordling J, Andersen JT, Bilde T, Meyhoff HH, Walter S. A patient weighted symptom score system in the evaluation of uncomplicated benign prostatic hyperplasia. Scand J Urol Nephrol Suppl. 1991; 138:59–62.
16. Wang Y, Hu H, Xu K, Wang X, Na Y, Kang X. Prevalence, risk factors and the bother of lower urinary tract symptoms in China: a population-based survey. Int Urogynecol J. 2015; 26:911–919.
Article
17. Ho LY, Chu PS, Consigliere DT, Zainuddin ZM, Bolong D, Chan CK, et al. Symptom prevalence, bother, and treatment satisfaction in men with lower urinary tract symptoms in Southeast Asia: a multinational, cross-sectional survey. World J Urol. 2018; 36:79–86.
Article
18. Kobayashi K, Fukuta F, Masumori N. Prevalence of post-micturition dribble in Japanese men and its relationship with benign prostatic hyperplasia/lower urinary tract symptoms. Low Urin Tract Symptoms. 2017; 12. 19. DOI: 10.1111/luts.12210. [Epub].
Article
19. Lee WC, Kim MT, Choo MS, Ko K, Shin TY, Jeong HB, et al. Study on post-micturition dribble in patients with lower urinary tract symptoms [abstract]. Annu Meet Korean Urol Assoc. 2014; Abstract No. O-163.
20. Frankel SJ, Donovan JL, Peters TI, Abrams P, Dabhoiwala NF, Osawa D, et al. Sexual dysfunction in men with lower urinary tract symptoms. J Clin Epidemiol. 1998; 51:677–685.
Article
21. Wein AJ, Coyne KS, Tubaro A, Sexton CC, Kopp ZS, Aiyer LP. The impact of lower urinary tract symptoms on male sexual health: EpiLUTS. BJU Int. 2009; 103:Suppl 3. 33–41.
Article
22. Shafik A, Shafik IA, El Sibai O, Shafik AA. Study of the response of the penile corporal tissue and cavernosus muscles to micturition. BMC Urol. 2008; 8:4.
Article
23. Bleustein CB, Arezzo JC, Eckholdt H, Melman A. The neuropathy of erectile dysfunction. Int J Impot Res. 2002; 14:433–439.
Article
24. Giuliano F, Rampin O. Central neural regulation of penile erection. Neurosci Biobehav Rev. 2000; 24:517–533.
Article
25. Ferrer JE, Velez JD, Herrera AM. Age-related morphological changes in smooth muscle and collagen content in human corpus cavernosum. J Sex Med. 2010; 7:2723–2728.
Article
26. Costa C, Vendeira P. Does erectile tissue angioarchitecture modify with aging? An immunohistological and morphometric approach. J Sex Med. 2008; 5:833–840.
Article
27. Stephenson TP, Farrar DJ. Urodynamic study of 15 patients with postmicturition dribble. Urology. 1977; 9:404–406.
Article
28. Wille S, Mills RD, Studer UE. Absence of urethral post-void milking: an additional cause for incontinence after radical prostatectomy? Eur Urol. 2000; 37:665–669.
29. Bader P, Hugonnet CL, Burkhard FC, Studer UE. Inefficient urethral milking secondary to urethral dysfunction as an additional risk factor for incontinence after radical prostatectomy. J Urol. 2001; 166:2247–2252.
Article
30. Millard RJ. After-dribble. In : Millard RJ, editor. Bladder control: a simple self-help guide. Sydney: Williams & Wilkins;1989. p. 89–90.
31. Pomfret IJ. Understanding post-micturition dribble incontinence in men. Nurs Times. 2003; 99:56–57.
32. Robinson J. Post-micturition dribble in men: causes and treatment. Nurs Stand. 2008; 22:43–46.
Article
33. Bø K, Talseth T, Holme I. Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ. 1999; 318:487–493.
Article
34. Paterson J, Pinnock CB, Marshall VR. Pelvic floor exercises as a treatment for post-micturition dribble. Br J Urol. 1997; 79:892–897.
Article
35. Wespes E, Nogueira MC, Herbaut AG, Caufriez M, Schulman CC. Role of the bulbocavernosus muscles on the mechanism of human erection. Eur Urol. 1990; 18:45–48.
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