Pelvic floor exercises for treating post-micturition dribble in men with erectile dysfunction: a randomized controlled trial.
OBJECTIVE
The purpose of this trial was to compare the efficacy of pelvic floor muscle exercises and manometric biofeedback for post-micturition dribble (PMD) in men with erectile dysfunction.


METHODS
Fifty-five men with erectile dysfunction (median age 59.2 years; range 22-78) were enrolled from a local urology clinic. Twenty-eight subjects were randomized to an intervention group and received pelvic floor muscle exercises including a strong post-void "squeeze out" pelvic floor muscle contraction, biofeedback, and suggestions for lifestyle changes. Twenty-seven control subjects were solely advised on lifestyle changes. The PMD status, anal manometry, and digital anal muscle grade were assessed at baseline, 3, and 6 months. After 3 months, the control group received the intervention with pelvic floor muscle exercises and biofeedback. Both groups were followed for an additional 3 months of home exercises. An independent assessor who was blinded to the grouping assessed the PMD status of subjects at 3 and 6 months.


RESULTS
Thirty-six (65.5%) of the 55 subjects reported PMD at baseline. At 3 months, there was significant reduction in PMD after intervention (p=0.001) compared to the control subjects (p=0.102). In both groups combined after 3 months of pelvic floor muscle exercises and 3 months of home exercises, 27 (75%) subjects became asymptomatic of PMD, 3 (8.3%) improved, 5 (13.9%) dropped out, and 1 (2.8%) subject still reported PMD. PMD was not correlated to age, erectile function, anal manometric pressure, or digital anal muscle grade.


CONCLUSIONS
Pelvic floor muscle exercises including a post-void "squeeze out" pelvic floor muscle contraction are an effective treatment for post-micturition dribble in men with erectile dysfunction.
Dorey
Grace
G
Faculty of Health and Social Studies, University of the West of England, Bristol, United Kingdom.
Speakman
Mark
M
Feneley
Roger
R
Swinkels
Annette
A
Dunn
Christopher
C
Ewings
Paul
P
D000328:Adult; D000368:Aged; D000465:Algorithms; D001676:Biofeedback, Psychology / Q000379:methods*; D018592:Cross-Over Studies; D003663:Decision Trees; D007172:Erectile Dysfunction / Q000150:complications*; D005081:Exercise Therapy / Q000379:methods* / Q000592:standards; D006801:Humans; D008019:Life Style; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017773:Pelvic Floor; D012107:Research Design; D016037:Single-Blind Method; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D014563:Urodynamics