THE SIGNIFICANCE OF TERMINAL DRIBBLING IN MEN WITH LOWER URINARY-TRACT SYMPTOMS

Objective To determine the relationship between the symptom of termina l dribbling, objective evidence of terminal dribbling on recordings of uroflow, benign prostatic enlargement (BPE) and bladder outlet obstru ction (BOO) in men with lower urinary tract symptoms (LUTS). Patients and methods The prevalence of the symptom of terminal dribbling was de termined from a symptom questionnaire completed by 165 men presenting with LUTS. Objective evidence of terminal dribbling during voiding was assessed from uroflow recordings and prostate volume was measured by transrectal ultrasonography. Combined pressure-now studies were perfor med to determine the presence or absence of BOO. Results There was rel atively poor agreement between the symptom of terminal dribbling and o bjective evidence of its presence; 48% of the patients who reported te rminal dribbling most or all of the time showed no objective evidence of terminal dribbling on uroflowmetry. The symptom of terminal dribbli ng was not significantly related to the presence of BOO (P=0.74) and t he group-specific urethral resistance factor (URA) did not differ sign ificantly (P=0.79) between those men who complained of terminal dribbl ing and those who did not (median URA 33 and 31 cmH(2)O, respectively) , However, objective evidence of terminal dribbling on uroflow traces was significantly related to BOO (P<0.001) and those patients with obj ective evidence of terminal dribbling had higher values of URA (median 39 compared with 28 cmH(2)O). Objective terminal dribbling had a spec ificity of 92% and positive predictive value of 88% for the presence o f BOG. Neither the symptom of terminal dribbling nor objective evidenc e of its presence were significantly related to prostatic enlargement. Conclusion While the symptom of terminal dribbling is probably not re lated to BOO or prostatic enlargement, objective evidence of terminal dribbling on now curve recording is specific for BOO and as such, its presence could potentially be of value in the assessment of men with L UTS.