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    Post Micturition Dribble (PMD)

    08:31AM, 25 August, 2020


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    "No matter how much you Jingle and Jangle, the last few drops of urine will end up in your pants!"


    Have you had the sensation of a single or few drops of urine constantly remaining in your pee-pee after leaving the toilet?

    Does this occasionally cause embarrassment?


    You are likely to have a condition called Post Micturition Dribble (PMD) which is the term used when an individual describes the involuntary loss of urine immediately after he or she has finished passing urine, usually after leaving the toilet in men, or after rising from the toilet in women.


    It differs from Terminal dribble mainly in a temporal way since this latter is the term used when an individual describes a prolonged final part of micturition, when the flow has slowed to a trickle/ dribble.

    Hence, post micturition dribble is clearly separated from micturition. It is an involuntary loss of urine being then a form of incontinence.


    Few men admit to having this problem but a great many suffer from it and are often badly embarrassed by it. Men of all ages can be affected.


    What causes these unwanted 'Drops of Jupiter'?


    No one exactly knows but it is thought to be caused by residual urine trapped at the prostatic urethra (the area between the internal and external urethral valve or sphincter) in males and usually in a urethral diverticulum (an abnormal out-pouching of the urethra) in females. PMD is usually a benign condition that causes embarrassment more than anything else.


    There are two proven ways of dealing with this problem.


    One is to perform pelvic floor exercises, the other is to push the last few drops of urine from the urethra with the fingers before the final shake, which we call " Milking of the Urethra".


    To push the last remaining drops of urine from the urethra the technique is as follows:

    1. After passing urine, wait for a few seconds to allow the bladder to empty by gravity

    2. Place the fingertips of the left hand three finger-breadths behind the scrotum and apply gentle pressure

    3. Keeping the pressure in the mid line, gently but positively draw the fingers forwards towards the base of the penis under the scrotum.


    This pushes the urine forward into the penile urethra from where it can be emptied by shaking or squeezing in the usual way, which we call the "Jingle and Jangle"!


    Before leaving the toilet, repeat the technique twice to ensure that the urethra is completely empty.

    This technique can be practiced at home. When in public toilets it can be done discreetly, with a hand inside a trouser pocket. It only takes a few seconds and may avoid the problem of wet trousers.


    How does Pelvic Floor Exercises help?

    Imagine contracting your pelvic floor muscles after finishing peeing. These short bursts of contraction help evacuate the last few drops of urine out of your urethra. Usually in combination with Milking of the Urethra, it helps to empty the passage before you park the 'Lizard'.


    And talking about parking of the "Lizard", it is recommended to place it in the 'Zenith Position' or at 12 O'clock and to wear a slightly tighter pair of jocks and avoid the looser boxer shorts.


    Also for men, it is recommended to sit and pee. The sheer act of getting up from the toilet seat will lead to squeezing of the urethra, expelling that last ml of urine. Spending that little extra time before zipping up may also help.


    Should all these methods fail, a visit to you friendly neighborhood Spiderman (Urologist) is highly recommended!



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