Background
Methods
Study population
Terminal dribbling definition and confirmation
Features measured using transrectal ultrasonography
Acquisition of IPSS questionnaires
Statistical analysis
Results
Characteristics of enrolled patents
Variables | All cases (n = 578) | Terminal dribbling (n = 226) | Non-Terminal dribbling (n = 352) | p value |
---|---|---|---|---|
Age (years), mean ± SD | 62.4 ± 10.8 | 62.2 ± 10.3 | 62.6 ± 11.03 | 0.775 |
PSA (ng/ml), median [IQR] | 2.22 [0.75-5.46] | 1.70 [0.73-4.81] | 2.65 [0.76-5.87] | 0.098 |
Prostate volume (cm3), median [IQR] | 31.0 [23.0-44.0] | 29.0 [22.0-43.0] | 32.0 [23.0-45.0] | 0.261 |
Prostate transitional zone volume (cm3), median [IQR] | 12.0 [7.0-20.0] | 10.0 [6.0-18.0] | 13.0 [7.25-22.0] | 0.116 |
IPSS total score, Mean ± SD | 14.1 ± 8.67 | 15.7 ± 8.33 | 13.1 ± 8.72 | <0.001 |
Voiding subscale score, mean ± SD | 8.13 ± 5.76 | 9.23 ± 5.44 | 7.43 ± 5.85 | <0.001 |
Storage subscale score, mean ± SD | 5.99 ± 3.70 | 6.49 ± 3.67 | 5.66 ± 3.66 | 0.008 |
IPSS QoL score, Mean ± SD | 3.64 ± 1.15 | 3.83 ± 1.07 | 3.51 ± 1.20 | 0.002 |
IPP (%) | 248 (42.9 %) | 100 (44.2 %) | 148 (40.2 %) | 0.402 |
Mild (%) | 362 (15.3 %) | 12 (12.0 %) | 26 (17.6 %) | |
Moderate (%) | 149 (60.1 %) | 64 (64.0 %) | 85 (57.4 %) | |
Severe (%) | 65 (24.6 %) | 24 (24.0 %) | 37 (25.0 %) |
The risk factors for terminal dribbling in the logistic regression analysis
Variable | Logistic Regression | ||
---|---|---|---|
OR | 95 % Confidence interval | p value | |
Age | 1.00 | 0.98 – 1.02 | 0.707 |
PSA | 0.98 | 0.94 – 1.02 | 0.262 |
Prostate volume (cm3) | 1.00 | 0.99 – 1.01 | 0.626 |
Prostate transitional zone volume (cm3) | 0.98 | 0.96 – 1.00 | 0.089 |
IPP | 1.41 | 0.96 – 2.09 | 0.083 |
IPSS total | 1.00 | 0.93 – 1.07 | 0.901 |
Voiding subscore | 1.06 | 1.02 – 1.09 | 0.001 |
Storage subscore | 0.96 | 0.88 – 1.05 | 0.384 |
IPSS QoL | 1.15 | 0.94 – 1.41 | 0.170 |
Variable | Logistic Regression | ||
---|---|---|---|
OR | 95 % Confidence interval | p value | |
Age | 0.99 | 0.97 – 1.01 | 0.530 |
PSA | 0.97 | 0.92 – 1.02 | 0.273 |
Prostate volume (cm3) | 1.00 | 0.99 – 1.01 | 0.752 |
Prostate transitional zone volume (cm3) | 1.00 | 0.99 – 1.02 | 0.713 |
IPP | 2.83 | 1.91 – 4.21 | <0.001 |
IPSS total | 0.96 | 0.89 – 1.04 | 0.363 |
Voiding subscore | 1.03 | 0.93 – 1.15 | 0.561 |
Storage subscore | 1.01 | 0.96 – 1.07 | 0.600 |
IPSS QoL | 1.23 | 0.98 – 1.55 | 0.070 |
Discussion
Source | Study sample | Prevalence | Questionnaires used | Definition of terminal dribbling | Remark |
---|---|---|---|---|---|
Boyarsky et al. (1977) 4 | Not a clinical study | Not determined | A pilot questionnaire with 10 items | No specific definition of terminal dribbling. | Suggested a guideline with a 10 item questionnaire including terminal dribbling. |
Garraway et al. (1991)20 | Community sample | 45 % | A pilot questionnaire by Fowler16 | Patients were asked to rate the frequency of dribbling after urination. (Confusion with post-void dribbling) | Uroflowmetry and transrectal ultrasonography were done. Undetermined impact of terminal dribbling |
Meyhoff et al. (1993)12 | LUTS patients | Not determined | DAN-PSS-1 | “Do you experience dribbling after voiding, when you feel you have finished urination?” (Confusion with post-void dribbling) | Post-void dribbling was aggravated after transurethral prostatectomy. |
Chute et al. (1993) 13 | Community sample | 36–44 % | A pilot questionnaire by Epstein18 | “Dribbling after urinating.” (Confusion with post-void dribbling) | Uroflowmetry and transrectal ultrasonography were done. Terminal dribbling was noted to be bothersome. |
Reynard et al. (1996)6 | LUTS patients | 44 % in questionnaire, 27 % in uroflowmetry | Not determined | “Does your urinary stream end with a dribble?” Gradient of a line drawn between the maximum flow rate and the end of flow was <0.25 and if, in the terminal 15 s of uninterrupted flow, the flow rate did not exceed 5 ml/s at any point. | Pressure-flow study was done. Terminal dribbling on questionnaire was not related to BOO defined by pressure-flow study. |
Hughes et al. (2000)1 | Community sample | 35 % | ICS male questionnaire | “Do you have any trickle/dribble at the final part of micturition?” | Terminal dribbling was the single- most bothersome symptom. |
Scarpa et al. (2001)2 | LUTS patients | 88 % | ICS male questionnaire | “Do you have any trickle/dribble at the final part of micturition?” | Terminal dribbling was the both most common and bothersome symptom |
Jin et al. (2003)3 | LUTS patients | 85.6 % | ICS male questionnaire | “Do you have any trickle/dribble at the final part of micturition?” | Translated questionnaire in Korean. Pressure-flow study was done. IPP was not checked. |
Yano et al. (2004)16 | LUTS patients | Not determined | Saitama Prostate Symptom Score | “Do you experience dribbling after voiding, when you feel you have finished urination?” | Validation study with IPSS. Pressure-flow study was done. Undetermined impact of terminal dribbling. |
Shiri et al. (2005)14 | Community sample | 52 % | DAN-PSS-120 | “Do you consider your urinary stream as dribbling?” | Relationship between LUTS and ED. Terminal dribbling was related to ED. |