Voiding posture as an associated factor of postmicturition dribble: insights from a nationwide epidemiological survey in Japanese men

PURPOSE: To investigate factors associated with postmicturition dribble (PMD) across a wide age range, with emphasis on behavioral and functional factors beyond conventional mechanisms related to lower urinary tract symptoms (LUTS). METHODS: This was a subanalysis of a nationwide web-based epidemiological survey conducted by the Japanese Continence Society. Overall, 3,122 men aged 20-99 years were included. PMD was assessed using a questionnaire, and demographic, clinical, lifestyle, and LUTS-related variables, including voiding posture and erectile dysfunction, were analyzed. Multivariable logistic regression analysis was performed to identify factors associated with PMD in the overall cohort and in men aged ≤ 50 years. RESULTS: PMD was reported by 467 men (15.0%). Among 1,450 men aged ≤ 50 years, PMD was present in 12.8%, despite low prevalences of self-reported history of benign prostatic hyperplasia (2.3%) and overactive bladder (7.1%). In the overall cohort, erectile dysfunction (adjusted odds ratio [OR]: 1.35, 95% confidence interval [CI]: 1.04-1.76) and frailty (adjusted OR: 1.75, 95% CI: 1.11-2.75) were independently associated with PMD, together with LUTS-related factors including overactive bladder, weak urinary stream, intermittent urinary stream, and abdominal straining at the end of voiding. In men aged ≤ 50 years, sitting voiding posture was independently associated with PMD (adjusted OR: 1.55, 95% CI: 1.02-2.36), along with LUTS-related factors. CONCLUSIONS: PMD is a common multifactorial condition affecting men across age groups. Beyond LUTS-related factors, exploratory age-stratified analyses identified sitting voiding posture as associated with PMD in men aged ≤ 50 years, although no significant age interaction was observed.