Stop Post-Void Dribble: How to Retrain Urinary Dyssynergia

One of the most maddening symptoms of a hypertonic pelvic floor (CPPS) is urinary dysfunction. You feel an intense, constant urge to urinate, yet when you try, you have to push forcefully. When you finish and pull your pants up, a few drops inevitably leak out.

This is known as Urinary Dyssynergia combined with a spastic bulbospongiosus muscle, and it's a completely mechanical problem that can be corrected.

The Bulbospongiosus & "The Kinked Hose"

Your bulbospongiosus muscle wraps directly around the base of your penis and the urethra. It acts as the "pump" that clears the last bits of urine (and semen) from the pipe.

However, when you have CPPS or Hard Flaccid, this muscle is constantly cramped. A cramped bulbospongiosus clamps down on the urethra like a kink in a garden hose, trapping urine right where the penis meets the perineum. This causes the infamous "post-void dribble" and constant irritation at the tip of the penis.

Tactics to Correct the Plumbing

Until your pelvic floor heals entirely, you need to change how you urinate to prevent further irritation and straining.

• Sit Down to Pee: Standing requires your core and pelvic floor to stay engaged to stabilize your body. Sitting down completely takes the structural load off your pelvic floor. Lean forward with your elbows on your knees and allow the pelvic shelf to drop.
• The Double Voiding Method: Spastic muscles exhaust quickly and clamp shut halfway through a stream. When your stream stops but you know you aren't empty, do not push! Sit there for 30-60 seconds, take 5 slow belly breaths, and wait. The muscle will relax, and a second effortless flow will start.
• Manual Milking for the Dribble: Forget dabbing the tip with toilet paper. You must physically push the trapped urine past the "kinked hose." When finished peeing, reach behind your testicles and press two fingers firmly up into your perineum. Drag them forward toward the base of your penis 2-3 times to manually clear the pipe.