Urine leaking after urinating
What is After-dribble? | Men
Urinary incontinence
Post micturition incontinence (commonly known as after-dribble) can occur when men leak a small amount of urine (wee) after emptying their bladder.
What is Post micturition incontinence?
Post micturition incontinence (commonly known as after-dribble) can occur when the muscles that surround the urethra (the tube that carries urine from the bladder to the penis) do not contract properly. This stops the bladder from fully emptying. A common cause of post micturition incontinence is an enlarged prostate or weakened pelvic floor muscles.
MANAGEMENT
The following can help minimise post micturition incontinence :
- Sit down on the toilet to empty your bladder.
- Place your fingertips (three fingers wide) behind your scrotum and apply gentle pressure upwards and forwards to encourage the flow of urine along and down the urethra, then shake or squeeze the penis in the usual way.
Repeat this movement twice to make sure the urethra is completely empty.
SEEK HELP for post micturition incontinence
It is important that you seek professional help if you have post micturition incontinence and any of the following symptoms:
- difficulty starting the flow of urine
- having to strain to empty your bladder
- a slow urine stream when emptying your bladder
- feeling the need to urgently empty your bladder
- burning, discomfort or pain when emptying your bladder
- blood-stained urine
- having to get up one or more times during main sleep time to empty your bladder (nocturia)
- having to change your lifestyle because of problems with your bladder or bowel.
Speak to your doctor or contact the National Continence Helpline on 1800 33 00 66.
The National Continence Helpline is staffed by Nurse Continence Specialists who offer free and confidential information, advice and support. They also provide a wide range of continence-related resources and referrals to local services.
100
Last Updated: Mon 23, Aug 2021
Last Reviewed: Fri 27, Mar 2020
Urinary incontinence
Learn more
Understanding incontinence
1 in 4 people are affected by incontinence. Incontinence can range in severity from a small leak to complete loss of bladder or bowel control.
About the bladder
Learn about how the bladder works, the signs of a healthy bladder, and problems that can occur.
About the pelvic floor
Learn about how pelvic floor muscles work and how to keep them strong.
Download resources
Browse our range or resources on bladder, bowel and pelvic floor health.
Subscribe and receive Bridge Magazine straight to your inbox.
SubscribePost Micturition Dribble (PMD) | Bladder & Bowel Community
What is Post Micturition Dribble?
Post Micturition Dribble (PMD), or after dribble, is the name given to the problem when men experience an involuntary loss of urine immediately after they have finished passing urine, usually after leaving the toilet.
It is not caused by stress from exertion or due to a problem with the bladder, and it should be distinguished from terminal dribble, which occurs at the end of passing urine. The condition can be a nuisance and cause embarrassment. It may occur in women but it is much more common in men.
Most men with PMD urinate normally however PMD is likely to occur when the penis is being replaced and clothes rearranged after a visit to the toilet. Trousers can end up getting wet. Men usually find that even after waiting and gently shaking, the problem remains.
What causes Post Micturition Dribble?
PMD is due to a weakness of the muscles of the pelvic floor which surround the urethra. The pelvic floor muscles can be weakened by:
- Operations for an enlarged prostate
- Continual straining to empty the bowels especially when constipated
- Constant cough, for example, a smoker’s cough
- Overweight
- Neurological damage
- Persistent heavy lifting
Other signs of urinary dysfunction are not normally present, although some men have symptoms such as urgency, frequency, hesitancy and straining.
For older men, they may develop PMD following a prostatectomy and may have associated urinary symptoms.
GET YOUR FREE JUST CAN'T WAIT CARD
Access the Universally Recognised Digital Just Can’t Wait Toilet Card Online for FREE Order the original toilet access card from the Bladder and Bowel Community today. We use the universally acknowledged W.C. signage, giving you the…
Can it be treated?
Few men admit to having this problem but a great many suffer from it and are often badly embarrassed by it. Men of all ages can be affected. There are two proven ways of dealing with this problem. One is to perform pelvic floor exercises, the other is to push the last few drops of urine from the urethra with the fingers before the final shake.
Pelvic floor muscle exercises or pelvic floor muscle rehabilitation can, if done correctly, help you improve your bladder and bowel control and resolve or improve leakage. They can also be used to help you if you already have symptoms of pelvic floor weakness.
When a muscle is not exercised it will weaken through lack of use. Like any other muscles in the body, the more you use and exercise them, the stronger the muscles will be. The pelvic floor muscles are no exception.
To find out how to perform pelvic floor muscle exercises please see our information sheet Pelvic Floor Exercises For Men.
Pelvic Floor Exercises For Men
[BBC:030] Pelvic Floor Exercises For Men
Training your pelvic floor muscles can help improve your bladder control and this is as important for men as it is for women. This guide explains how to perform pelvic floor exercises.
How to Reduce Post Micturition Dribble
To push the last remaining drops of urine from the urethra the technique is as follows:
- After passing urine, wait for a few seconds to allow the bladder to empty
- Place the fingertips of the left hand three finger-breadths behind the scrotum and apply gentle pressure
- Keeping the pressure in the mid line, gently but positively draw the fingers forwards towards the base of the penis under the scrotum
- This pushes the urine forward into the penile urethra from where it can be emptied by shaking or squeezing in the usual way
- Before leaving the toilet, repeat the technique twice to ensure that the urethra is completely empty.
This technique can be practiced at home. When in public toilets it can be done discreetly, with a hand inside a trouser pocket. It only takes a few seconds and may avoid the problem of wet trousers.
Further Information
If you are concerned about your problem and it is starting to affect your day-to-day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems. You can also obtain further advice on overactive bladder treatments.
Bladderbladder conditionspost micturition dribble
Urine leakage after urination (dribbling): etiology and treatment
- Etiology
- Treatment
- Pelvic floor exercises for men (Dorey, 2006)
Dribbling is the term used for a symptom where men experience inadvertent loss of urine immediately after urinating, usually after leaving the toilet.
These symptoms are present in 17% of healthy adult men and in 67% of patients with lower urinary tract symptoms (LUTS). Leakage of urine after urination does not threaten the life of patients, but leads to a sharp deterioration in its quality.
Leakage of urine after urination is caused by insufficiency of the bulbocavernosus muscle ( m.bulbocavernosus ), which surrounds the middle and proximal parts of the urethra (urethra). Normally, after urination, m.bulbocavernosus reflexively contracts and contributes to the "evacuation" of urine from the urethra. Urinary leakage is associated with retention of urine in the bulbar urethra, followed by the release of the latter during movement or under the influence of gravity.
What can cause leakage of urine after urination:
- Urethral strictures
- Urethral diverticulum
- Tumors of the urethra
- Hypertrophy of the seminiferous tubercle (seminal tubercle)
- Colliculitis (inflammation of the seminiferous hillock)
- Bladder neck obstruction
- Urinary tract infections
- Weak pelvic muscles
- Ejaculation (orgasm)
- Prostatitis (prostate enlargement due to inflammation)
- Benign prostatic hypertrophy (adenoma)
- Prostate cancer
- Obesity
- Diseases of the spine (hernias)
- Injuries of the spinal cord
- Neurological diseases
- Diseases associated with impaired blood supply to the brain
- Certain medicines (medicines for the treatment of osteoporosis)
- Operations on the pelvic organs (prostatectomy, adenomectomy, transurethral resection of the prostate)
Make an appointment
Make an appointment with a urologist by calling 8(812)952-99-95 or by filling out the online form - the administrator will contact you to confirm the appointment
The Uroclinic Center guarantees complete confidentiality
Treatment options depend on the etiology of the disease.
To combat leakage when there is no underlying disease, we recommend:
- carefully “milk” the urethra, i.e. place fingers behind the scrotum and gently massage the bulbar urethra forward and upward to evacuate residual urine from the urethra;
- perform a series of rhythmic pelvic movements before inserting the penis into the briefs;
- regularly perform exercises to strengthen the muscles of the pelvic floor.
-
Standing:
Stand up straight with your legs apart and tighten your pelvic floor muscles as if you were trying to avoid losing balance from a strong gust of wind (if you look in the mirror, you will see the root of the penis moving closer to the stomach and pulling / contracting the scrotum). Hold the contraction as hard as you can without holding your breath or tightening your buttocks. Perform three maximum (as strong as possible) contractions in the morning, holding for 10 seconds and three maximum contractions in the evening.
-
Sitting:
Sit on a chair with your knees apart and tense your pelvic floor muscles. Hold the contraction as hard as you can without holding your breath or tightening your buttocks. Perform three maximum (as strong as possible) contractions in the morning, holding for 10 seconds and three maximum contractions in the evening.
-
Lying down:
Lie on your back, knees bent, knees apart. Technique - as in a sitting position.
-
While walking:
Raise your pelvic floor muscles slightly while walking.
-
After urination:
After emptying the bladder, tighten the pelvic floor muscles upward as much as possible to avoid dripping urine.
If the problem persists or is more severe, if you have symptoms other than a few drops of urine after urination, see a urologist for advice and evaluation.
It is not customary to talk about it: urinary incontinence in women
Some topics related to intimate health are under an unspoken ban.
They are embarrassed to talk about them even with close people. When the problem is not discussed, it seems that it does not exist. Often a woman suffering from urinary incontinence believes that she is the only one so "wrong", and is very ashamed of her disorder. Actually it is not. Let's see what the statistics say.
| According to experts from the Cleveland Clinic (USA), 10% of women suffer from urinary incontinence. After age 65, the prevalence of this condition increases to 35%. Often the problem is completely solvable, there are effective methods of treatment. But many women are embarrassed to go to the doctors. In Russia, the situation is no better. In our country, it is generally customary to turn to doctors, “when everything is already very bad.” Especially when it comes to such delicate issues. |
No need to be afraid, shy and endure. If you are faced with this unpleasant problem, the doctors of the Sova clinic will definitely help you.
And you can be sure that no one except our doctor will know about your disorder.
Depending on the manifestations, there are several types of urinary incontinence:
- Stress urinary incontinence is the most common. Leaks happen when pressure builds up in the abdomen: during laughing, sneezing, coughing, exercising, lifting weights. The most common cause of this condition is the weakening of the pelvic floor muscles, the prolapse of the vagina and uterus.
- Urgent incontinence. When the urge to urinate occurs, the woman does not have time to run to the toilet. This is due to overactive muscles in the wall of the bladder.
- Persistent urine leakage . It is caused by a violation of the nervous regulation of the bladder, the work of the sphincter muscles, which normally should retain urine.
- Reflex urinary incontinence is the result of nerve impulses from the brain not reaching the bladder. For example, this condition develops after serious damage to the spinal cord.
- Leakage of urine after urination . Due to muscle dysfunction, after going to the toilet, there is still some urine left in the bladder, which then flows out under the influence of gravity.
- Bedwetting (enuresis) is diagnosed in women and girls over 5 years of age if involuntary urination occurs during sleep.
Why is urinary incontinence more common in women, and what causes it?
The prevalence of the problem among men is only 1.5% - almost ten times less than in women. This is due to some features of female anatomy and physiology.
During pregnancy, 4 out of 10 women experience urinary incontinence, especially in the third trimester. As the fetus grows, it puts more and more pressure on the bladder, urethra, and pelvic diaphragm. The muscles that support the pelvic organs are stretched, as a result, urinary retention is impaired.
During childbirth, the pelvic floor muscles are even more stressed.
They stretch, squeeze the nerves. Usually within 6 weeks, the muscles recover and no more urine leaks occur. If the disorder persists, a doctor should be consulted.
Women have a shorter urethra compared to men. Because of this, with an increase in intra-abdominal pressure, urine leaves the bladder more easily.
During menopause and as a result of age-related changes in the body, the muscles of the pelvic floor continue to weaken and stretch, changes in the mucous membranes occur.
Stress urinary incontinence is a very common condition among modern women. It can and must be fought. Self-medication with folk methods will not help here. Visit a doctor.
This is serious
Stress urinary incontinence is not just an unpleasant symptom, it can greatly affect all areas of life. The psycho-emotional state of a woman suffers, she has complexes, anxiety, she tries not to stay outside the house for a long time, because “this” can happen at the most unexpected moment.
Relations with the opposite sex suffer, work, you have to limit yourself in many things.
Increased risk of urinary tract infections. Due to the constant exposure to urine, irritation, rash, and itching appear on the skin.
How to treat urinary incontinence?
Before starting treatment, you need to understand the causes of the disorder. This often requires a thorough examination. Urinary incontinence in women is diagnosed and treated by gynecologists and urologists. After examination, the doctor may prescribe a general and bacteriological analysis of urine, measurement of residual urine (which remains in the bladder after urination) using ultrasound. The patient is asked to keep a notebook, in which she must record the amount of fluid drunk and urine excreted, the number and time of urges, episodes of incontinence.
When the cause is clearly and unambiguously established, treatment can begin. There are many methodologies.
Temporary urinary incontinence can be caused by a urinary tract infection.
Usually the problem disappears as soon as the underlying disease is eliminated. Doctors of the Sova clinic successfully treat cystitis and other infectious and inflammatory pathologies. Do not wait for complications, make an appointment with a specialist.
There are special methods of "training" the bladder and pelvic floor muscles:
- Kegel exercises, named after the American gynecologist who developed them, strengthen the pelvic floor. You need to tighten up, as if you are trying to stop the flow of urine, and try to keep the muscles in this state for 10 seconds. It is recommended to perform the exercise 3 times a day for 10 sets.
- Urinary retention: when there is a desire to urinate, you need to endure a few more minutes.
- Double urination: a few minutes after going to the toilet, you need to urinate again.
- "Scheduled urination": need to go to the toilet in advance at a certain time (every 2-4 hours), and not when you really want to.
When lowering the vagina and uterus, pessaries are used - rings made of a special material that are inserted into the vagina. To strengthen the muscles, electrical stimulation is used with electrodes inserted into the vagina or rectum. Sometimes a device that resembles a pacemaker is implanted under the skin - it sends impulses to the muscles. The doctor may prescribe various medications, correction with fillers that reduce the lumen of the urethra. Botulinum toxin injections help with an overactive bladder.
Modern manufacturers offer a huge selection of simulators for the pelvic muscles. These devices can have a different shape, they are inserted into the vagina. Some devices just need to be held inside, straining the muscles, others have the function of vibration, electrical stimulation. They can be connected to a smartphone and set training programs. Such exercise machines can be beneficial, but before using them, it is worth consulting with your doctor.
