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

Author:

Albakr Ahmed1ORCID,El Ansari Walid234ORCID,Mahdi Mohammed156ORCID,Megahed Heba2ORCID,Lock Merilyn7ORCID,Arafa Mohamed138ORCID,Hothi Hanaa Al1ORCID,Ghafouri Ardalan13ORCID

Affiliation:

1. Urology Department Hamad Medical Corporation Doha Qatar

2. Department of Surgery Hamad Medical Corporation Doha Qatar

3. Weill Cornell Medicine Doha Qatar

4. Department of Postgraduate Medical Education, College of Medicine Qatar University Doha Qatar

5. Department of Surgery, Division of Urology McGovern Medical School at UTHealth Houston Texas USA

6. Department of Urology MD Anderson Cancer Center Houston Texas USA

7. Division of Exercise Science, Health and Epidemiology, College of Health and Life Sciences Hamad Bin Khalifa University Doha Qatar

8. Andrology Department Cairo University Cairo Egypt

Abstract

AbstractIntroductionPostmicturition 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.

Publisher

Wiley

Subject

Urology,Neurology (clinical)

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3