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Getting urine dribble during defecation and have constipation. What treatment should be done?

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Practicing since : 1991
Answered : 1414 Questions
Dear Doctor

After passing Urine Completely particularly during Taking bath and during defecation,Urine dribbles
Out again Always,Some times Urine Stream is Weak,My Age is 40 years
Somtimes there is wetting in my inner wear after I come back after passing urine

When I had increase in urination frequency I consulted with a general doctor and had a
Ultrasound of Lower pelvis to check if it was due to prostate. Those results were normal. I took
antibiotics Augemtin for 1 week. This course was complete a month back. I also had
Uroflowmetry. The flow was on 18ml/sec and doctor said it was on lesser side there was
some obstruction as the curve was broken in between. He put me on Urimax 0.4 mg for 30 days
and suggested to do a uroflowmetry test again. It is one week now after this

Apart from this I have constipation problems and usually need to strain to clear bowel.
Sometimes I am unable to clear bowel completely at the end. For this I consulted a Gastroenterlogist
and the doctor said might be IBS and prescribed course of tablets, IBSET (2 weeks),
Capsule VXL #3 (1 month). Normaxin (2 weeks). Peg Move. this course is complete

After all this I visited a urologist who did a rectal examination and physical examination. He said might
motion is blocking after rectal examination. Upon physical examination he tried to move the foreskin
back and there was litte discomfort. He asked me if it wa always like this. I dont remember this as
I never had these problems earlier or I have overlooked. But i said during my first intercourse I had
pain and had foreskin issue. The doctor told me that I might be having mild phimosis and suggested
circumcision to remove skin. He asked me to wait for current Urimax course to see if there is any
improvement. If there is not much improvement he asked to visit again

I dont have any other health problems. (I have dandruff).
I have posted this for your opinion as this is taking a toll on me and am getting worried

I have attached all reports (Ultrasound scan of lower pelvis, uroflow metry and Urnie analysis)

Kind regards
Posted Fri, 23 Nov 2012 in Men's Health
Answered by Dr. G.Srinivasan 3 hours later

Welcome to XXXXXXX and thanks for your query, ESPECIALLY for addressing it to me.

What you experience is called TERMINAL DRIBBLE of urine.
Urine dribble during defecation is normal for many people, because both bladder and rectum have common nerve supply, but dribble in underpants on a regular basis needs to be looked into.
It can occurs in patients with prostate enlargement, people with long foreskin or stricture urethra ( local or general narrowing of the path of urine).
Uroflow XXXXXXX flow rate of 18 per second is little less, but not abnormal. I am not worried about the break in the center.
The scan and urine analysis are normal.
It is worth while waiting for the one month course of urimax to be completed and reassess your progress clinically and repeat uroflow if needed.
If there is no significant improvement, a cystoscopy is recommended during circumcision to assess the urethra and the prostate.

The problem is quite treatable and there should not anything serious.

Hope this answers your query, kindly get back for doubts if any.

Above answer was peer-reviewed by
Follow-up: Getting urine dribble during defecation and have constipation. What treatment should be done? 43 hours later
Dear Dr,

Thanks for your response. I assume that circumcision has to be done. Can you please tell how this is done and what usually happens and how much time it takes to get back to normal after circumcision

Answered by Dr. G.Srinivasan 3 hours later

Welcome back.
The procedure essentially involves removal of the foreskin and suturing the cut portion of the skin back. This exposes the glans penis (head of the penis) so that collection of smegma and urine does not occur between the foreskin and the glans, in order to maintain good hygiene.
Anesthesia - The procedure takes about 30 to 45 minutes. It can be done under local injection alone in that area to make in numb with or without supplementation by sleeping injections. With this method, you can go home after 6 to 8 hours.
Fasting may be necessary for 6 hours prior.
The alternative is to do under a spinal anesthetic - an injection in the back that makes the area numb below the belly button. In this situation, you may have to stay for 24 hours in the hospital after the procedure.
Postop care - pain killers will be given orally/ rectally or by injections and you will be taken care of well.
Dressing - will be inspected after a day or two and then can be left open with an ointment to apply over the area.
The uncovered part of the penis may be sensitive for 3 to 4 weeks and hence you may have to cover it with gauze or a soft cloth and then wear undergarments.
Showers can be taken once the first dressing is out.
The sutures usually need not be removed and they wither in 3 to 4 weeks’ time.

Hope this answers you query.

Above answer was peer-reviewed by
Follow-up: Getting urine dribble during defecation and have constipation. What treatment should be done? 11 minutes later
I did not mean to ask another question. I would want to close this discussion. Anyway I have one more query In one forum I read that Alphablockers will help this. Does it provide relief for cases like this
Answered by Dr. G.Srinivasan 13 minutes later

Welcome back.
Alpha blockers like urimax would hep if there is benign prostatic enlargement or prostatitis to some extent.
That is why, in the initial discussion, i had suggested to complete the course of urimax and reassess.
Hope the discussion has helped you.

Wishing you best health.
Above answer was peer-reviewed by
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