What Causes Post Micturition Leakage?

Post Micturition Leakage, also known as Post Micturition Dribble (PMD) is a common problem in men. It occurs when men experience an involuntary loss of urine after they have finished passing urine.

Experiencing post micturition leakage does not mean you do not urinate normally. You may not notice any additional symptoms, however, you will find that you experience urine leakage when the penis is being replaced and clothes are rearranged after a visit to the toilet. The condition can be frustrating, as trousers can end up getting wet and men can find that the problem remains even after waiting and shaking. The condition is much more common in men than in women. The condition results in a small patch of urine staining the underpants.

What is Causing your Post Micturition Dribble?

The male urethra, which is about 15-20cm long, is not a straight tube. The urethra is more accurately shaped like an upturned “S”. It is therefore likely that if urine collects in the upper curve, it might not come out while you are urinating. This causes it to drip out after you have finished urination. This condition does not, therefore, have the same meaning as terminal dribble, which occurs at the end of passing urine.  Post micturition leakage is not caused by stress from exertion or due to a problem with the bladder.  Instead, the condition is caused by weakness of the pelvic floor muscles that surround the urethra. This weakening can be caused by a variety of surprising reasons. These include operations for an enlarged prostate, constipation, having a constant cough, being obese, having neurological damage or persistent heavy lifting. When this condition occurs in women, it is often due to urine being trapped in a urethral diverticulum.

How can you Treat the Condition?

Unfortunately, there are no known effective drug or surgical treatments for this condition. There is, however, a technique recommended for individuals who struggle with pushing the remaining drops of urine from the urethra. You can carry out the following steps to do this correctly:

• Wait a couple of seconds after passing urine for the bladder to empty
• Next, place the fingertips of the left hand three finger-breadths behind the scrotum. Now, gently apply pressure.
• Keeping this pressure, gently draw the fingers towards the base of the penis under the scrotum

This technique should push the urine forward into the penile urethra. From here, it can be emptied by shaking or squeezing in the usual way. You should repeat this technique twice to ensure the urethra is completely empty.

For further help in preventing post micturition leakage, pelvic floor muscle exercises or pelvic floor muscle rehabilitation can help. They are also helpful if you already have symptoms of pelvic floor weakness. Remember that practice makes perfect, and the more you use and exercise them, the stronger the muscles will be. Experts also recommend that you pull your pants and the elastic of your briefs down properly so that both the penis and scrotum are fully exposed when you empty the bladder. Doing this will cause the elastic from your briefs to apply some pressure behind the scrotum and help to straighten the urethra so that it is completely emptied.

It is also important to not become dehydrated or avoid drinking liquid to try and stop this problem from happening. Instead, you should stay hydrated and spread fluid consumption throughout your day to prevent your bladder from becoming overloaded.

Exercising the pubococcygeal muscles which support the pelvic floor muscles can also help to regulate the urination process. Regularly contracting these muscles can gradually improve your urine control and help you to empty your bladder more effectively. They can also minimize leakage and improve urine control. You should start with 10-20 kegel exercises a day and gradually work up to 100. You will know that you’re working the right muscles when it feels just like it does when you’re trying to stop peeing.

Lastly, try not to worry too much about this condition as it is normally not a cause of worry. If this condition interferes with your daily life, however, you shouldn't hesitate to contact a Doctor. If you have any other symptoms apart from a few drips, you should also consult your doctor and ask for an examination, particularly if you are of young age.

The following tests are commonly ordered by Doctors:

• Neurological tests: These are tests such as urodynamics, imaging, EEG, and EMG that help the doctor confirm or rule out the presence of a nerve disorder.

• Cystometry: The cystometry measures the pressure inside the bladder and checks for the possibility of muscle or nerve problems that may cause frequent urination.

• Urinalysis and urine culture: These tests detect and measure various components of the urine. A urine culture can detect bacteria that may be the cause of a urinary tract infection.
• Ultrasonography: This imaging test is used to visualize your kidneys and bladder to detect any structural abnormalities or tumours. The test is non-invasive, therefore you shouldn't be scared about this procedure.

Although many men have this problem, only a few men admit to having this problem. If this problem is happening to you frequently, you shouldn't hesitate to invest in a small absorbent pad designed for light incontinence.