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QUESTION: Hi doctor:

This is what you answered to my last question.

It is not possible to give a course on urology or urinary anatomy on this forum so I really can't "peruse other voiding trouble or prostate trouble".

Dribbling refers to a slow urine flow, usually a few drops.  It may be continuous or episodic such as after voiding.  Urinary retention means complete inability to void.  This sometimes happens with dribbling.  Incontinence just means leakage of urine in any amount.

If you are having sufficient dribbling to have it run down your leg then this is more than just a minor issue and you should have your physicians look into it.  Meanwhile, something like a Cunningham clamp can be used to control the dribbling until a better solution presents.

One of the biggest problems in Toronto Canada is getting a referral to a urologist, could be a few months or longer.

My GP cannot help me I am sure.

Anyway, considering the dribbling is not that serious. It's not like I am getting allot of urine on my underwear or so. Maybe it could also be sweat. Can urine be coming from somewhere else other than the penis.

Also, I am starting to change my eating habits and coffee drinking habits, lets see how this works for me.

I one of your response you said the way the penis is shaped, it is always going to have some drops stuck.

My question is if I did go to see a Urologist, what type of test would he do? Cystoscopy, urine retention test ultrasound?

What if after the tests nothing is found like obstructions, etc?

What happens than? Just live with it?

ANSWER: Joe:

I can't determine if your dribbling is serious or not. You could have urinary retention with overflow dribbling which is a bit more serious than some minor leakage problem.  Urine would not normally be coming anywhere except from the penis but there are sometimes abnormal passages or fistulas that can do this.  I cannot say what types of tests the urologist might do, but a urinalysis, physical exam, history and an ultrasound check of the residual urine might be a good first step.  Therefore, I can't speculate on what may be done later.

---------- FOLLOW-UP ----------

QUESTION: Hi doctor
Iam not too sure what urinary retention with overflow dribbling.
As I can't see anyone for a while. I have had all the above tests done already, and they always come out perfect.

Why don't I just see what happens in the next few weeks to see if things improve. I will change my diet, less coffee, no spicy foods. I am not too sure how bad this dribbling is? Why is it going down my leg, at least I feel it down my one leg (right)?

My question is with the numerous tests and guess work, ultimately if they don't find anything what happens than?

ANSWER: Joe:

Urinary retention with overflow dribbling means that the bladder is totally full, is unable to empty and that causes the dribbling.  It can easily lead to permanent bladder damage, infections and renal failure so it can be dangerous.

At thsi point, I cannot determine how dangerous your dribbling might be, but if it's as bad as you claim it really should be checked by a physician.

If after all the testing required no definitive cause can be found, then the cunningham clamp might help.  You can look this up on the internet.

---------- FOLLOW-UP ----------

QUESTION: Hi Doctor:

I am not too sure if it is overflow dribbling, because I don't feel that Ican't empty completely. I do feel a little dribbling down my leg, however, it is allot better to-day. I do however, have to go more often at night, which usual for me.

Please note that I usually get this problem always around the winter time. Than it goes away when the weather gets better. Also, I  mentioned before, I have been eating poorly ( allot of spicey and heavy greasy foods, and more coffee than usual). I have started a new diet eleminating allot of this stuff. I don't have to go to bathroom as much, especially when I am at work. So after a few months it could completely correct itself. I also, get treatments from alternative medicine, such as chiropracter, and especially accupunturist, that I find really helps me.


I will montor the situation if things get worse, as you indicated above such as infections ( I never get any infections, every test that I take comes out positive).

Finally, looking at everything to-day, I don't feel so bad, and very little dribbling at all. Maybe only if I stand or walk. Will monitor for sure. If things get worse I will go to the doctor immediately.

If you have any other comments would be appreciated.

Answer
Joe:
Just one comment.  I strongly recommend that you consult a urologist and have this looked at just in case it is one of the more serious problems.  You cannot make this determination yourself unless you happen to own a home ultrasonic bladder scanner.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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