Dribbling After Urinating - Why It Happens And What To Do About It  - National Association For Continence (2024)

Women may experience a feeling of “dribbling” after urinating for many reasons. It may feel like they are unable to fully empty their bladder. This article will explain the condition, discuss potential causes, and suggest ways to treat it, highlighting double-voiding as a common technique.

Though dribbling after urination is more likely to affect men, women get it, too[1].

A study[2] conducted in 1997 reported that the prevalence of post-void dribbling in women was 30% to 50%. Depending on the age group, the highest prevalence is among women aged 65 to 74. However, it is important to note that this study was conducted on a specific population of women. Hence the prevalence of post-void dribbling in the general population of American women may differ. Coupled with the limited sample size with many women’s reluctance to reportthe loss of bladder control due to embarrassment or a belief that it is expected due to age, the exact prevalence of post-void dribbling in women is difficult to determine.

A discomfort among women with post-void dribbling is the feeling of incomplete bladder emptying, damp underwear, and an urge to urinate shortly after just emptying the bladder or leaking immediately after urination. And it usually happens right after leaving the toilet.

But if it happens, know that you’re not alone. More importantly, nothing is embarrassing or shameful about pee dribble after urination.

Firstly, post-void dribbling is a medical condition and not a reflection of personal hygiene or cleanliness.

Secondly, it is a common condition that can happen to many women, especially with age and among those with multiple vagin*l childbirth. Hence, do not let itaffect your esteem or increase your anxiety, avoiding social engagements and risking isolation.

Understandably, many women may feel uncomfortable and awkward about discussing their symptoms with a healthcare provider or loved ones. Still, it is crucial to seek medical attention if you are experiencing post-void dribbling.

While it is common, it is not a regular occurrence.

It can significantly impact your quality of life, and urine dribble may be accompanied by other symptoms, such as a sudden urge to urinate, difficulty starting or stopping, or pain or discomfort during urination.

In addition, there could be underlying medical conditions, such as pelvic organ prolapse, urinary tract infections, neurological disorders, and hormonal imbalances.

Depending on the condition, many treatment options are available to help reduce post-void dribbling, ranging from simple pelvic floor exercises to medications and surgery. Furthermore, seeking medical attention and discussing your symptoms openly and honestly enables you to understand how it happens and assuages any bad feelings you may have.

Weaknesses in the pelvic floor muscles, which support the bladder, uterus, and rectum, can lead to difficulty controlling urine flow. In addition, aging itself — followed by lower estrogen levels during menopause, further weaken the pelvic floor.

The baby’s weight during pregnancy, the physical strain of childbirth, and being overweight or obese can put additional pressure on the pelvic floor muscles. In addition, chronic bronchitis or asthma can cause frequent coughing or sneezing, which strains the pelvic muscles. Similarly, high-impact physical activities such as running and jumping or straining during bowel movements can cause further damage to the pelvic floor muscles.

It is important to note that having a weak pelvic floor does not necessarily mean a person will experience symptoms such as urinary incontinence or prolapse. But, a strengthened pelvic floor muscle through exercises such as Kegels can help improve bladder and bowel control, reduce the risk of pelvic organ prolapse, and improve the overall quality of life.

Bladder prolapse is the most common type of pelvic organ prolapse. It occurs when the tissues and muscles that support the bladder weaken, causing the bladder to drop down and push against the vagin*l walls. This can happen due to various factors, including pregnancy and childbirth, menopause, obesity, chronic coughing, and repetitive heavy lifting.

When the bladder drops down, it can put pressure on the urethra. This pressure can cause the urethra to open when it shouldn’t, leading to urine leakage, particularly after urination.

Urinary tract infections (UTIs) are bacterial infections in the urinary system which cause inflammation and irritation of the bladder and urethra. As there is pain or burning sensation during urination, the bladder muscles cannot squeeze properly to empty the bladder fully.

When the bladder drops down, it can put pressure on the urethra. This pressure can cause the urethra to open when it shouldn’t, leading to urine leakage, particularly after urination.

Certain medications, such as diuretics and alpha-blockers, can cause an increase in urine production or interfere with bladder function. In the case of diuretics, these are medications that increase urine production and can lead to more frequent urination and risk of overflow incontinence. Think of your bladder as a water pitcher. If you only pour some of the water out of the pitcher but not all of it, there’s still a risk that you could spill when you move around. People with overflow incontinence never completely empty the bladder — placing them at risk for a pee dribble, usually in small drips over time instead of one big gush of urine.

Alpha-blockers are medications used to treat high blood pressure and other conditions. They work by relaxing the receptors to the organ cells, and bladder neck muscles may be one of them. Hence it can interfere with normal bladder function and lead to post-void dribbling.

Suppose you are experiencing post-void dribbling as a result of medication. In that case, it is essential to consult with a healthcare provider. They may recommend adjusting the dosage or switching to a different medication to reduce the risk of post-void dribbling. Do know that sometimes the medicine’s benefits may outweigh the risks of post-void dribbling. Hence the dosage may remain, but your healthcare provider may recommend other treatments to manage urine dribble.

In some cases, the cause may be unclear. For instance, some people may have weaker pelvic floor muscles due to genetic factors predisposing them to pelvic organ prolapse and urine dribble. However, this area is still being researched.

It could also be due to your diet. The food and drink you take do not cause post-void dribbling. However, if these diets cause the bladder to become overactive and irritated and if you are already experiencing symptoms of urine dribble, your diet may aggravate it.

Even if the cause of the symptom is unclear, it is still advisable to consult with a healthcare provider for proper diagnosis and treatment.

A key thing to remember is that your bladder does not empty all the urine. A normal urine residual is less than 50 mL[3]. In older adults, between 50 and 100 mL is considered normal. However, a residual greater than 200 mL is considered abnormal and indicative of incomplete bladder emptying.

Hence, the fretting feeling of incomplete bladder emptying and, as a result, frequent urination to try to empty the bladder. Because pee dribbles once you stand up, there is always the feeling of dampness or wetness in your underwear.

Top of the list and most straightforward to start is strengthening your pelvic floor muscles with exercises and maintaining good pelvic health.

The Kegel exercise is the most commonly prescribed measure to tone your pelvic floor. It was named after gynecologist Dr. Arnold Kegel, who invented it as a non-surgical treatment for pelvic organ prolapse and urinary incontinence. It helps you to reduce symptoms of urine leaks and, at the same time, keep your pelvic floor healthy.If the exercises are helping after this time, you can keep doing them. Research[4] suggests that women who complete pelvic floor muscle training experience fewer leaking episodes.

Once you have finished, apply the double voiding method to empty your bladder completely. Essentially, it means after urination, wait a few moments, and then try to urinate again using the following steps :

• Sit for another 15-45 seconds, then lean forward and sit up straight again.
• Stand up, move around, and sit down again.

It is a technique that can be helpful for women who experience urinary urgency or frequency or are at risk for urinary tract infections.

There are, however, certain conditions where double voiding may not work or may not be appropriate. For example, some women may have an overactive bladder or a pelvic organ prolapse, which can cause frequent urination and urgency. Double voiding may not be effective in this case, as the bladder may continue to fill up rapidly even after double voiding.

Post-void dribbling can be caused by various reasons. It may be a symptom of a more significant health problem such as pelvic organ prolapse, neurological related, and being diabetic. It could result from normal aging, hence a weak pelvic muscle, especially if you had multiple vagin*l births. Your medications and regular diet could also cause irritable bladder and urine dribbling. Plus, if you are overweight, that could be the cause, too. While it sounds like a common occurrence, it is not normal.

Like all diseases and their symptoms, there is nothing to be embarrassed about leaking urine after pee, impacting your emotional wellness, and giving up your everyday social interactions. The

condition is already stressful and disruptive; coupled with the anticipation of the diagnosis from your healthcare provider, you should avoid burdening your psychosocial health and affecting your esteem.

Hence seeking medical advice and exploring appropriate treatment plans according to the severity and causes is essential. You can even start by making simple lifestyle changes, keeping a record of voiding frequency, doing regular Kegal exercises, and trying double voiding. All of which you can manage in your private space. Your healthcare provider may advise physiotherapy, medications, or surgery to your treatment plan to address further underlying bladder issues if needed.

[1] https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/post-micturition-dribble/#:~:text=It%20may%20be%20experienced%20in,a%20visit%20to%20the%20toilet

[2] David H. Thom, Mary N. Haan, Stephen K. Van Den Eeden, Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality, Age and Ageing, Volume 26, Issue 5, September 1997, Pages 367–374,https://doi.org/10.1093/ageing/26.5.367

[3] Kelly CE. Evaluation of voiding dysfunction and measurement of bladder volume. Rev Urol. 2004;6 Suppl 1(Suppl 1):S32-7. PMID: 16985853; PMCID: PMC1472847.

[4] Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4. PMID: 30288727; PMCID: PMC6516955.