Editor name: Luis Abranches-Monteiro
Latest Update: August 2018
Current definition
Post micturition dribble (PMD) is the term used when an individual describes the involuntary loss of urine immediately after he or she has finished passing urine, usually after leaving the toilet in men, or after rising from the toilet in women. [1]
History
It differs from Terminal dribble mainly in a temporal way since this latter is the term used when an individual describes a prolonged final part of micturition, when the flow has slowed to a trickle/ dribble [1].
Hence, post micturition dribble is clearly separated from micturition. It is an involuntary loss of urine being then a form of incontinence.
A survey was conducted to investigate postmicturition dribble in the general adult male population. The incidence of postmicturition dribble in the men in their 20s, 30s, 40s and 50s, was 11.5, 13.2, 19.4 and 26.9%, respectively. The overall incidence was 17.1%. Of those who had experienced postmicturition dribble; 14.0% dribbled almost daily but the degree of postmicturition dribble was limited to spotting or wetting of the underwear in 93.2%. Therefore, 2.3% of all respondents answered that they had experienced postmicturition dribble almost daily. It is concluded that postmicturition dribble is fairly common in adult men. [2]
A Finnish study showed that half of the 30-year-old men and two-thirds of the men aged 60-80 years had postmicturition dribble. Dribbling into trousers increased with age but as a severe symptom, it was rare (0.5%). [3]
When in conjunction with other symptoms a functional or anatomical abnormality of the lower urinary tract was found in every patient [4]
Controversy
The mechanisms are diverse. Some patients have a hyperactive detrusor while others show a urine bulbar residue, even in the absence of a urethral stenosis. [5] [6]. When the cause is an urethral stenosis
In these cases, the more distal and severe the stenosis, the more likely to present a post micturition dribble.
It is a multi-mechanism symptom, ranging from the result of post micturition detrusor contractions, to delayed emptyng of urethral residues due to any difficulty in emptying, like a distal urethral stenosis.
References
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Society., Standardisation Sub-committee of the International Continence, “The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society,” Neurourol Urodyn., Vols. 21(2):167-78., 2002;
Furuya S, Ogura H, Tanaka M, Masumori N, Tsukamoto T., “[Incidence of postmicturition dribble in adult males in their twenties through fifties,” Hinyokika Kiyo, pp. .;43(6):407-10., 1997 Jun.
Pöyhönen A1, 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., pp. ;46(6):418-23, 2012 Dec.
Corcoran M, Smith G, Chisholm GD., “Indications for investigation of post-micturition dribble in young adults.,” Br J Urol. , pp. ;59(3):222-3, 1987 Mar.
Stephenson TP, Farrar DJ., “Urodynamic study of 15 patients with postmicturition dribble.,” Urology. , pp. 9(4):404-6., 1977 Apr;.
Suruya S, Yokoyama E., “Urodynamic studies on postmicturition dribble,” Hinyokika Kiyo., pp. ;29(4):395-400., 1983 Apr.
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. , pp. 108(9):1452-8, 2011 Nov.