From the Guidelines
Post-void dribbling in young adults is often caused by urethral stricture, and the most effective solution is a combination of lifestyle changes, medical interventions, and potentially surgery, as recommended by the American Urological Association guideline 1.
Causes of Post-Void Dribbling
- Urethral stricture: a narrowing of the urethra that can cause obstructive voiding symptoms, including post-void dribbling 1
- Other urologic conditions, such as benign prostate enlargement, bladder outlet obstruction, and abnormal detrusor function, can also present with similar symptoms 1
- Detrusor underactivity, which can result in incomplete bladder emptying and post-void dribbling 1
Solutions for Post-Void Dribbling
- Lifestyle changes:
- Strengthening pelvic floor muscles through Kegel exercises, performing 3 sets of 10-15 contractions daily, holding each contraction for 5-10 seconds
- Reducing bladder irritants like caffeine, alcohol, and acidic foods
- Maintaining a healthy weight to decrease pressure on the bladder
- Scheduling bathroom trips every 2-3 hours to train the bladder
- Practicing double voiding (urinating, waiting a moment, then trying again) to ensure complete emptying
- Medical interventions:
- Anticholinergics (oxybutynin, tolterodine) or beta-3 agonists (mirabegron) for overactive bladder symptoms
- Topical estrogen for women with post-void dribbling
- Urethral dilation or direct visual internal urethrotomy (DVIU) for urethral stricture
- Surgery:
- Urethroplasty or other surgical procedures to repair or remove the urethral stricture
Diagnosis and Evaluation
- Clinicians should include urethral stricture in the differential diagnosis of men who present with decreased urinary stream, incomplete emptying, dysuria, urinary tract infection (UTI), and rising post-void residual (PVR) 1
- Uroflowmetry, ultrasound post-void residual (PVR) assessment, and urethro-cystoscopy can be used to diagnose and evaluate urethral stricture 1
- Determination of urethral stricture length and location is essential for treatment planning and patient counseling 1
From the Research
Causes of Post-Void Dribbling
- There is no direct evidence in the provided studies to suggest the causes of post-void dribbling in young adults.
- However, urinary tract infections (UTIs) are a common issue in adult populations, and the provided studies focus on the treatment and management of UTIs 2, 3, 4, 5.
- It is possible that post-void dribbling may be related to UTIs or other urinary issues, but more research is needed to determine the specific causes.
Solutions for Post-Void Dribbling
- The provided studies do not offer any solutions for post-void dribbling specifically.
- However, the studies do discuss the treatment and management of UTIs, which may be related to post-void dribbling.
- For example, the studies suggest that antimicrobial therapy, such as trimethoprim-sulfamethoxazole, nitrofurantoin, or fosfomycin, may be effective in treating UTIs 2, 3, 4.
- Additionally, the studies discuss the importance of individualized assessment of risk factors for resistance and regimen tolerability in choosing the optimum empirical regimen for UTIs 2, 3, 5.
- It is possible that similar approaches may be effective in managing post-void dribbling, but more research is needed to determine the best course of treatment.
Urinary Incontinence
- One of the studies discusses urinary incontinence in women, which may be related to post-void dribbling 6.
- The study suggests that unsupervised pelvic muscle exercises and lifestyle modifications, such as weight loss and adequate hydration, may be effective in reducing symptoms of urinary incontinence.
- Additionally, the study discusses the use of urgency incontinence medications and specialist treatments, such as onabotulinumtoxinA and percutaneous or implanted neuromodulators.
- However, it is unclear whether these approaches would be effective in managing post-void dribbling specifically, and more research is needed to determine the best course of treatment.