Post-Urination Dribbling: Causes and Solutions

Regarding urinary incontinence?

Hello, doctor.
I have a question.
Since I was in high school, after I finish urinating, I notice that when I walk a few steps, I feel a slight drop or two of urine coming out.
This causes the area of my glans that comes into contact with my underwear to become yellowish.
I don't feel overly anxious while urinating; I try to relax.
I remember that when I was younger, I could leave immediately after urinating.
Now I have to wait and shake a few more times.
(Additionally, I wonder if this is due to using many muscles or nerves in the lower body while walking, causing residual urine to leak out.
I don't feel like I have incomplete emptying or residual urine, and urination is not painful or burning, so I don't think I have prostatitis.
I have also had a urinalysis done.
I've heard that there might be bubbles at the end of the urine stream; if there are bubbles, what does that indicate? What could happen?) Or is it a case of "pelvic floor muscle fatigue," leading to difficulty in closing tightly? I'm really worried, so I have started doing Kegel exercises.
Now I also practice the stop-and-start technique while urinating.
Is it normal for men to have this slight leakage, which is why I have to wash my underwear daily? I'm really concerned, and I kindly ask for your detailed response.
Thank you.

EQ, 30~39 year old female. Ask Date: 2009/10/28

Dr. Xu Weikai reply Urology

Hello, first of all, Kegel exercises aim to improve the strength of the pelvic floor muscles and are commonly used for women and for urinary incontinence after surgery.
Generally, normal males do not have issues in this regard; frequent practice may even lead to some side effects.
Additionally, the presence of bubbles in urine is not significant; testing is required to determine if there is any underlying disease.
Even if urine does not have bubbles, it is still possible to have a medical condition.
As for dribbling, sometimes it is due to the pants being too tight; when males urinate, part of the zipper may compress the urethra, causing it to be tense and preventing complete emptying of the bladder, which can result in some urine leaking into the underwear after putting on pants.
It is recommended to lower the pants to the knees while urinating to relieve pressure on the urethra.
Try this to see if it improves the situation.
If it does not improve, it is advised not to shake but to use toilet paper to dry off, which should also help alleviate this issue.

Reply Date: 2009/10/28

More Info

Post-urination dribbling, or the involuntary leakage of urine after urination, is a common issue that many men experience at some point in their lives. It can be particularly concerning when it leads to discomfort or embarrassment, as you have described. Understanding the causes and potential solutions can help alleviate your worries and improve your quality of life.

Causes of Post-Urination Dribbling
1. Anatomical Factors: The male urinary system is designed in such a way that the urethra passes through the prostate gland and the pelvic floor muscles. Any changes in these structures, whether due to age, surgery, or other medical conditions, can lead to dribbling.
2. Muscle Control: The pelvic floor muscles, including the sphincter muscles, play a crucial role in controlling the flow of urine. If these muscles are weak or fatigued, they may not close completely after urination, leading to residual urine leaking out. This phenomenon is sometimes referred to as "sphincter fatigue."
3. Nerve Function: The nerves that control bladder function can also impact how effectively urine is expelled and retained. If there is any nerve damage or dysfunction, it may lead to issues with bladder control.

4. Residual Urine: After urination, some men may have residual urine left in the urethra. This can be exacerbated by the act of walking or moving, which may cause the remaining urine to leak out.

5. Hydration and Urine Composition: The presence of bubbles in urine can sometimes indicate that the urine is concentrated or that there is a presence of air in the bladder, which can occur due to various reasons, including dehydration or urinary tract infections. However, if you have had a negative urine test for infection, this may not be a concern for you.

Solutions and Management
1. Kegel Exercises: As you mentioned, performing Kegel exercises can strengthen the pelvic floor muscles. These exercises involve contracting and relaxing the muscles that control urination. Regular practice can improve muscle tone and control, potentially reducing dribbling.

2. Post-void Dribbling Techniques: After urination, you can try techniques such as "double voiding," where you urinate, then wait a moment and try to urinate again to ensure the bladder is fully emptied. Additionally, gently squeezing the penis or using a "shake" technique can help expel any remaining urine.

3. Hydration: Staying well-hydrated can help dilute your urine, making it less concentrated and potentially reducing any irritation that may contribute to dribbling.

4. Consultation with a Specialist: If the problem persists or worsens, it may be beneficial to consult a urologist. They can perform a thorough evaluation, including a physical examination and possibly urodynamic testing, to assess bladder function and identify any underlying issues.

5. Lifestyle Modifications: Avoiding caffeine and alcohol, which can irritate the bladder, may also help. Maintaining a healthy weight and engaging in regular physical activity can improve overall pelvic health.

Conclusion
While post-urination dribbling can be a source of concern, it is often manageable with lifestyle changes and exercises. It is essential to listen to your body and seek medical advice if you notice any significant changes or if the issue persists. Remember, you are not alone in this experience, and many men face similar challenges. By taking proactive steps, you can improve your situation and regain confidence in your urinary health.

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