Post-micturition dribble (PMD)

Abstract: This research delves into the abnormal condition of post-micturition dribble (PMD), characterized by the involuntary leakage of urine following the completion of the main voiding stream.

Introduction: Post-micturition dribble represents a bothersome phenomenon characterized by the release of urine following the completion of voiding, often causing discomfort and embarrassment. This study aims to elucidate the multifactorial nature of PMD.

Potential Factors:

1. Prostate Issues: Enlargement or inflammation affecting the prostate gland.
2. Urethral Stricture: Narrowing of the urethra leading to incomplete emptying.
3. Pelvic Floor Dysfunction: Weakness or dysfunction of pelvic floor muscles.
4. Neurological Factors: Nerve damage affecting bladder control.

Prevalence Across Demographics: While research on prevalence across different demographic groups is limited, PMD is a common occurrence, affecting individuals across ethnic backgrounds, races, cultures, and continents.

PMD affects around 12% of men and just 8.5% of women worldwide!

Underlying Conditions:

1. Benign Prostatic Hyperplasia (BPH): Common in aging males, causing prostate enlargement.
2. Urethral Stricture: Scar tissue formation leading to incomplete voiding.
3. Pelvic Floor Dysfunction: Impaired muscle function affecting bladder control.

Pathomorphology: PMD arises from various factors, including mechanical obstruction, muscle weakness, or neurological dysfunction, resulting in residual urine in the urethra.

Symptoms and Signs:

1. Dribbling After Voiding: Involuntary leakage of urine following urination.
2. Incomplete Emptying Sensation: Feeling of residual urine in the bladder.
3. Increased Frequency: More frequent urination attempts to relieve the incomplete voiding sensation.

When to Suspect Post-Micturition Dribble (PMD): Consider PMD in individuals reporting persistent dribbling after completing the main voiding stream, especially if associated with incomplete emptying sensations.

Diagnostic Approaches:

1. Clinical History: Thorough inquiry into voiding patterns, associated symptoms, and medical history.
2. Physical Examination: Assessment of the prostate, urethra, and pelvic floor function.
3. Urodynamic Testing: Evaluates bladder and urethral function during voiding.
4. Imaging Studies: Ultrasound or cystoscopy to visualize the urinary tract.

Conditions Mimicking Post-Micturition Dribble (PMD):

1. Overflow Incontinence: Similar presentation due to bladder overdistention.
2. Pelvic Floor Dysfunction: Weak pelvic floor muscles causing post-void dribbling.

Differential Diagnosis: Thoroughly differentiate PMD from conditions with similar presentations to guide accurate diagnosis and tailored treatment.

Potential Therapies:

1. Pelvic Floor Exercises: Strengthening pelvic muscles to improve bladder control.
2. Behavioral Therapy: Training to enhance bladder emptying techniques.
3. Surgical Interventions: Prostate resection for BPH or urethral dilation for strictures.

Pharmaceuticals:

1. Alpha-Blockers: Tamsulosin, doxazosin, for improving urinary flow.
2. Muscle Relaxants: May be considered in cases of pelvic floor dysfunction.

This research aims to deepen the understanding of post-micturition dribble, aiding healthcare professionals in accurately diagnosing and managing the diverse underlying causes of this common urological concern

Verified by: Dr.Diab (December 21, 2023)

Citation: Dr.Diab. (December 21, 2023). How do you manage post-micturition dribble PMD?. Medcoi Journal of Medicine, 5(2). urn:medcoi:article17688.