Why Do I Experience Post-Void Dribbling? Urological Concerns

After each urination, there are always a few drops of urine that remain trapped at the tip and do not come out?

It started about two years ago, where I would have a few drops of urine trapped at the end of the urethra after urination.
No matter how much I shake, I can't seem to get it all out, and I also notice a significant lack of sensation at the tip of the glans.
Within about 1 to 2 minutes, my body exerts itself and a few more drops of urine will leak onto my underwear.
I have seen a urologist, and they confirmed that it is not nocturia or incontinence.
I underwent cystoscopy and urodynamic testing, and the doctors said everything is completely normal, but there has been no improvement.
Although it currently does not affect my daily life, I am worried that if it persists, it might lead to problems.
Some have suggested seeing a neurologist, wondering if there might be an issue with the nerves at the tip of the glans causing this.
However, the neurologist advised me to return to the urologist to confirm whether it is a neurological issue through urodynamic testing, but I already had that done and it showed no problems.
Do I really need to undergo that test again? I have seen many doctors for this issue, including traditional Chinese medicine, but nothing has worked.

notebook, 20~29 year old female. Ask Date: 2016/01/12

Dr. Xu Wencang reply Urology

You can try the "shake" technique; males have a longer urethra, which can sometimes lead to a few drops of urine remaining.
Additionally, practice Kegel exercises to control the pelvic floor muscles and manage the urinary sphincter.

Reply Date: 2016/01/12

More Info

Post-void dribbling, the phenomenon of experiencing a few drops of urine after finishing urination, can be a frustrating and sometimes embarrassing issue. It is not uncommon, and while it may not significantly impact daily life, it can lead to concerns about underlying urological or neurological issues.
From your description, it seems that you have been experiencing this issue for about two years, and despite consulting with urologists and undergoing various tests, including cystoscopy and urodynamic studies, the results have been normal. This suggests that there may not be any significant anatomical or functional abnormalities in your urinary tract. However, the persistence of the symptoms can understandably lead to anxiety about potential long-term complications.

Post-void dribbling can occur for several reasons:
1. Anatomical Factors: Sometimes, the anatomy of the urethra or the pelvic floor muscles can contribute to this issue. If the pelvic floor muscles are not functioning optimally, they may not provide adequate support to the bladder and urethra, leading to dribbling.

2. Neurological Factors: As you mentioned, there could be a neurological component to your symptoms. The nerves that control the bladder and urethra play a crucial role in the urination process. If there is any dysfunction in these nerves, it could lead to incomplete emptying of the bladder or difficulty in controlling the flow of urine.

3. Prostate Issues: In men, prostate enlargement or inflammation can also lead to urinary symptoms, including post-void dribbling. However, if your urologist has ruled out prostate issues, this may not be a concern for you.

4. Detrusor Muscle Function: The detrusor muscle is responsible for bladder contraction. If it does not contract effectively or if there is a delay in contraction after urination, it can lead to residual urine in the bladder, which may then dribble out after you think you are done.

Given that you have already undergone extensive testing, it may be worth considering a few additional steps:
- Pelvic Floor Therapy: Engaging in pelvic floor exercises or physical therapy may help strengthen the muscles involved in urination and improve your control.

- Neurological Evaluation: If you suspect a neurological cause, it may be beneficial to seek a second opinion from a neurologist who specializes in urological issues. They may suggest further tests to assess nerve function related to urination.

- Lifestyle Modifications: Sometimes, simple lifestyle changes can help manage symptoms. For instance, ensuring that you fully empty your bladder by leaning forward while urinating or using techniques to help expel any remaining urine can be beneficial.

- Follow-Up with Urology: If your symptoms persist, it may be worth revisiting your urologist for a follow-up. They might consider repeating the urodynamic studies or exploring other diagnostic avenues, such as imaging studies, to ensure there are no underlying issues that were missed.

In conclusion, while post-void dribbling can be a benign condition, it is essential to continue monitoring your symptoms and maintain open communication with your healthcare providers. If your symptoms change or worsen, or if you develop new symptoms, it is crucial to seek medical advice promptly. Your health and comfort are paramount, and there are often solutions available to improve your quality of life.

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