{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:45:45Z","timestamp":1785890745985,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Postmicturition 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To undertake a systematic review of the available treatments for primary PMD in adult males\u00a0and meta\u2010analysis of their effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We 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\u2010analysis was undertaken where feasible, and where this was not feasible, narrative synthesis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 335 studies, four were included (four\u00a0clinical trials, <jats:italic>n<\/jats:italic>\u2009=\u2009344 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\u2010reported complaint than counseling. Meta\u2010analyses of the two PDE5 inhibitors studies showed a large effect size with high heterogeneity for decreased PMD volume favoring PDE5 inhibitors over placebo (<jats:italic>g<\/jats:italic>\u2009=\u2009\u22120.86, 95% confidence interval [CI] \u22121.75; 0.02, <jats:italic>p<\/jats:italic>\u2009=\u20090.05; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200988%); and a significant improvement equivalent to \u22121.06 points on the Hallym PMD\u00a0Questionnaire score with no discernable heterogeneity (95%\u00a0CI \u22121.65; \u22120.47, <jats:italic>p<\/jats:italic>\u2009=\u20090.0004; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), favoring PDE5 inhibitors compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Physical\/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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25337","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T13:42:36Z","timestamp":1701351756000},"page":"1686-1698","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Postmicturition dribble in men with no previous urogenital surgery: Systematic review and meta\u2010analysis of treatment modalities"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5321-1707","authenticated-orcid":false,"given":"Ahmed","family":"Albakr","sequence":"first","affiliation":[{"name":"Urology Department Hamad Medical Corporation Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-1302","authenticated-orcid":false,"given":"Walid","family":"El Ansari","sequence":"additional","affiliation":[{"name":"Department of Surgery Hamad Medical Corporation Doha Qatar"},{"name":"Weill Cornell Medicine Doha Qatar"},{"name":"Department of Postgraduate Medical Education, College of Medicine Qatar University Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-2489","authenticated-orcid":false,"given":"Mohammed","family":"Mahdi","sequence":"additional","affiliation":[{"name":"Urology Department Hamad Medical Corporation Doha Qatar"},{"name":"Department of Surgery,\u00a0Division of Urology McGovern Medical School at UTHealth Houston Texas USA"},{"name":"Department of Urology MD Anderson Cancer Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2315-6193","authenticated-orcid":false,"given":"Heba","family":"Megahed","sequence":"additional","affiliation":[{"name":"Department of Surgery Hamad Medical Corporation Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3907-3883","authenticated-orcid":false,"given":"Merilyn","family":"Lock","sequence":"additional","affiliation":[{"name":"Division of Exercise Science, Health and Epidemiology, College of Health and Life Sciences Hamad Bin Khalifa University Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-8857","authenticated-orcid":false,"given":"Mohamed","family":"Arafa","sequence":"additional","affiliation":[{"name":"Urology Department Hamad Medical Corporation Doha Qatar"},{"name":"Weill Cornell Medicine Doha Qatar"},{"name":"Andrology Department Cairo University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7034-6101","authenticated-orcid":false,"given":"Hanaa Al","family":"Hothi","sequence":"additional","affiliation":[{"name":"Urology Department Hamad Medical Corporation Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5866-9047","authenticated-orcid":false,"given":"Ardalan","family":"Ghafouri","sequence":"additional","affiliation":[{"name":"Urology Department Hamad Medical Corporation Doha Qatar"},{"name":"Weill Cornell Medicine Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)02243-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000074"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.02.075"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.1998.00565.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.10014.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.06.023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.2019.60.3.142"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65544-9"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.03.134"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000020215"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223734"},{"key":"e_1_2_10_13_1","unstructured":"EAU Guidelines. 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