Population-level and Individual-level Bother of Lower Urinary Tract Symptoms Among 30- to 80-year-old Men

Pöyhönen, Antti; Auvinen, Anssi; Häkkinen, Jukka; Koskimäki, Juha; Tammela, Teuvo L.J.

doi:10.1016/j.urology.2016.06.023

Cited by 6 publications

(11 citation statements)

References 23 publications

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“…The internet‐based Epidemiology of LUTS study, which involved > 14 000 men, reported an overall prevalence rate of 46.2% . It is also suggested that PMD might be one of the most bothersome LUTS for men . In a population‐based study involving > 1700 men, PMD was defined as a moderate or severe bother symptom .…”

Section: Discussionmentioning

confidence: 99%

“…In a population‐based study involving > 1700 men, PMD was defined as a moderate or severe bother symptom . In the TAMUS study, men aged 30–40 years experienced the most bother from PMD . Furthermore, post‐micturition symptoms, including PMD, commonly overlap with other LUTS , thereby causing further aggravation.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies report PMD prevalence of > 50% [8][9][10]. Recent studies also suggest that PMD may be one of the most bothersome LUTS in men [8,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Effect of tadalafil 5 mg on post‐micturition dribble in men with lower urinary tract symptoms: a multicentre, double‐blind, randomized, placebo‐controlled trial

Yang

Jeong

et al. 2019

BJU International

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Objectives To compare the effects of taking tadalafil 5 mg and placebo once daily on post‐micturition dribble (PMD) in men with lower urinary tract symptoms (LUTS). Patients and Methods Our prospective, randomized, double‐blind, placebo‐controlled, multicentre trial enrolled 102 men with PMD and other LUTS. PMD was assessed using the Hallym Post‐Micturition Dribble Questionnaire (HPMDQ) and according to PMD volume. Over a 12‐week period, patients took either tadalafil 5 mg (n = 51) or placebo (n = 51) once daily and their HPMDQ and PMD volume results were evaluated. Adverse events (AEs) were also reported. Results Over the course of 12 weeks, total HPMDQscores and PMD volumes improved significantly more in the tadalafil group than in the placebo group (reduction of total HPMDQ score of ≥2 points in the tadalafil and placebo group in 68.8% and 31.9% of patients (P < 0.001) and decreased mean PMD volume in the tadalafil and placebo group at 0.48 mL and 0.22 mL, respectively (P = 0.046). Specifically, PMD frequency decreased and quality of life increased significantly more in the tadalafil group than in the placebo group (P = 0.029 and P < 0.001, respectively). Furthermore, 66.7% of the tadalafil group reported moderate and significant PMD improvement, whereas only 4.2% reported that tadalafil was ineffective. Treatment‐emergent AEs did not significantly differ between the groups (all P > 0.05), and no serious AEs were observed. Conclusion Taking tadalafil 5 mg once daily reduced PMD symptom severity and PMD volume in men with PMD, without inducing serious AEs, more effectively than placebo, suggesting that taking tadalafil 5 mg once daily may be an effective and well‐tolerated PMD treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of tadalafil 5 mg on post‐micturition dribble in men with lower urinary tract symptoms: a multicentre, double‐blind, randomized, placebo‐controlled trial

Yang

Jeong

et al. 2019

BJU International

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“…Another internet-based study involving 30,000 people from the general population reported an overall PMD prevalence of 46% [23]. PMD is considered as one of the most bothersome LUTSs as well as of the most common LUTSs [625]. In a population-based study involving 1,709 men, PMD was one of the most prevalent symptoms that caused moderate or severe bother among men [6].…”

Section: Discussionmentioning

confidence: 99%

“…In a population-based study involving 1,709 men, PMD was one of the most prevalent symptoms that caused moderate or severe bother among men [6]. Another study involving 7,470 men reported that men aged 30 to 40 years were bothered the most by PMD [25]. In addition, from a practical point of view, PMD is not included in the IPSS, which is the most widely used tool to evaluate LUTS worldwide.…”

Section: Discussionmentioning

confidence: 99%

Postmicturition Dribble Is Associated with Erectile Dysfunction in Middle-Aged and Older Men with Lower Urinary Tract Symptoms

Yang

Lee

et al. 2018

World J Mens Health

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PurposeLower urinary tract symptoms (LUTS) are correlated with erectile dysfunction (ED), but research on whether postmicturition dribble (PMD) is related to ED is limited. We assessed the correlation between PMD and ED in middle-aged and older Korean men with LUTS.Materials and MethodsIn our prospective, cross-sectional, observational, multicenter study, we enrolled 205 men (age >40 years) with LUTS. LUTS and ED were assessed using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5), respectively. PMD was assessed using the Hallym PostMicturition Dribble Questionnaire, Question 1, and the PMD volume was calculated in a paper test. Age, prostate volume, serum prostate-specific antigen, maximum urinary flow rate, and postvoid residual urine were also evaluated.ResultsThere were significant differences in the total and voiding IPSS between men with and without ED (p=0.042 and 0.043, respectively). The Hallym PostMicturition Dribble Questionnaire 1 score was inversely well correlated with the IIEF-5 score (r=−0.388, p<0.001). Also, the PMD volume was inversely correlated with the IIEF-5 score (r=−0.138, p=0.042). ED prevalence increased as the Hallym PostMicturition Dribble Questionnaire 1 score increased (p=0.002). Further, incorporating the Hallym PostMicturition Dribble Questionnaire 1 into the IPSS tended to increase the predictive accuracy of LUTS by 4.2% in ED patients (p=0.082).ConclusionsPMD was significantly correlated with ED and reinforced the relationship between LUTS and ED in middle-aged and older men. PMD might be an important component of the association between LUTS and ED.

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Postmicturition dribble in men with no previous urogenital surgery: Systematic review and meta‐analysis of treatment modalities

Albakr,

El Ansari,

Mahdi

et al. 2023

Neurourology and Urodynamics

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IntroductionPostmicturition dribble (PMD) is common in males. Little is known about PMD etiology, but it is either secondary to urethral/prostatic surgery or primary (no previous surgery). Despite PMD's high prevalence, the effectiveness of its treatment modalities remains lacking.ObjectiveTo undertake a systematic review of the available treatments for primary PMD in adult males and meta‐analysis of their effectiveness.Materials and MethodsWe searched four electronic databases from inception to 2023 for original articles that evaluated PMD treatments in male adults without previous urethral/prostatic surgery (PROSPERO protocol CRD42023444591). Study quality and risk of bias were evaluated using established tools. We extracted a range of variables including treatment modality used and its effectiveness on PMD volume and patient complaint. Meta‐analysis was undertaken where feasible, and where this was not feasible, narrative synthesis was conducted.ResultsOut of 335 studies, four were included (four clinical trials, n = 344 patients). Two trials used physical/behavioral therapy (pelvic floor muscle exercises [PFMEs], urethral milking); the other two employed phosphodiesterase (PDE5) inhibitors (tadalafil, Udenafil). All studies were of good quality, but physical/behavioral therapy studies had some risk of bias. As the two physical/behavioral therapy studies used heterogenous outcome measures, narrative synthesis showed PMD volume improvement with PFMEs more than with urethral milking, both modalities were more effective than counseling, and in one study, PFMEs were effective in reducing PMD self‐reported complaint than counseling. Meta‐analyses of the two PDE5 inhibitors studies showed a large effect size with high heterogeneity for decreased PMD volume favoring PDE5 inhibitors over placebo (g = −0.86, 95% confidence interval [CI] −1.75; 0.02, p = 0.05; I2 = 88%); and a significant improvement equivalent to −1.06 points on the Hallym PMD Questionnaire score with no discernable heterogeneity (95% CI −1.65; −0.47, p = 0.0004; I2 = 0%), favoring PDE5 inhibitors compared to controls.ConclusionsPhysical/behavioral therapy and PDE5 inhibitors are effective primary PMD treatments. PMD management studies in males with no previous urethral/prostatic surgery are very scarce and lack the use of consistent/comparable outcome measures. Further studies addressing these deficiencies would benefit this very thin evidence base.

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Population-level and Individual-level Bother of Lower Urinary Tract Symptoms Among 30- to 80-year-old Men

Cited by 6 publications

References 23 publications

Effect of tadalafil 5 mg on post‐micturition dribble in men with lower urinary tract symptoms: a multicentre, double‐blind, randomized, placebo‐controlled trial

Effect of tadalafil 5 mg on post‐micturition dribble in men with lower urinary tract symptoms: a multicentre, double‐blind, randomized, placebo‐controlled trial

Postmicturition Dribble Is Associated with Erectile Dysfunction in Middle-Aged and Older Men with Lower Urinary Tract Symptoms

Postmicturition dribble in men with no previous urogenital surgery: Systematic review and meta‐analysis of treatment modalities

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