Embarrassing postvoid dribble
DAVID BULLOCK, MD, of Castlegar, BC, wonders, "What's the mechanism of postvoid dribble in men? Is there a treatment?"
The logical explanation is that an enlarged prostate, just above the sphincter, compromises the tap's ability to close completely. This explanation is supported by the finding that surgical removal of the obstructing tissue (transurethral resection of the prostate) is associated with resolution of the dribbling problem in most instances. Cystoscopic evaluation before prostate surgery, though, can't usually detect sphincter compromise, which makes me wonder whether the dribbling isn't rather associated with a disturbance of the internal sphincter or bladder neck. I advise patients who complain to me about dribbling too much at the end of urination to place their fingertip just behind the scrotum and lift up the perineum. This will aid complete evacuation of the bladder and reduce the drops.