RecommendationExplain to men with post micturition dribble how to perform urethral milking.
Relative values of different outcomesPost-micturition urine loss measured by pad testing was the most important and relevant outcome as reduced post-micturition dribbling is the desired effect of the technique.
Trade off between clinical benefits and harmsBeing a safe and simple (easy to learn) procedure, the benefits largely outweigh the harms
Economic considerationsThere are costs associated with the time spent by healthcare professionals on offering advice about urethral milking.
However, these could be offset by minimising the costs of other types of management if the conservative strategy is successful.
Quality of evidenceThe evidence was in one small study of very low quality.

Two different ways of analysing the efficacy (urine loss) was used: mean urine loss adjusted for baseline level and unadjusted for baseline level. Only the adjusted mean reached statistical significance in this very small study.
Other considerationsIt would be very easy to implement if not already used in practice. There are leaflets available and many clinicians are aware of this technique. The technique is easy to learn and patients can usually master this technique in one session.

The clinical benefits (reduced urine loss) can be immediately observable in patients who had learned the technique.

From: 5, Conservative management for men with lower urinary tract symptoms

Cover of The Management of Lower Urinary Tract Symptoms in Men
The Management of Lower Urinary Tract Symptoms in Men [Internet].
NICE Clinical Guidelines, No. 97.
National Clinical Guideline Centre (UK).
Copyright © 2010, National Clinical Guideline Centre.

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