If you’ve been reading the popular Bottom Line article, “Do You Pee in Your Pants After You Pee? There’s a Cure for That“, you’ve likely just learned a new term: post-micturition dribble. But how does that problem relate to other, more common urination issues, such as overactive bladder (OAB) and urinary incontinence? The first step toward fixing what’s wrong with your urination is finding out what’s wrong with it. So here’s how to tell the difference between “peeing after you pee”…overactive bladder…and urinary incontinence…

Overactive Bladder

What is it? Also called irritable bladder, overactive bladder (OAB) is what it sounds like… you feel the urge to urinate far more frequently than is typical.

Normally, as your bladder fills with urine, the organ signals the brain so that you experience that “I have to go” feeling. It starts mild and increases to a strong sense of urgency. In OAB, that signaling system misfires, and you jump right from nothing happening to extremely urgent. That sudden urge to urinate is often difficult to control, so it can lead to leaking urine before you can get to the bathroom. When that happens, it’s called urge incontinence (see below). People with OAB also urinate frequently, usually eight or more times in 24 hours—and often wake up two or more times at night to pee.

Who gets it? OAB becomes more common with age, although it’s not an inevitable part of aging. It affects more women than men. Women who have gone through menopause and men who have an enlarged prostate (or who are recovering from prostate cancer treatments) are at greater risk. People with certain diseases (diabetes, stroke, multiple sclerosis) are at high risk, too—and medication side effects can also lead to OAB symptoms. In addition, bladder infections (such as a urinary tract infection) or interstitial cystitis, a chronic inflammation also known as painful bladder syndrome, can cause transient symptoms of OAB—they get better when the infection clears up. But quite often, there’s nothing that your doctor can find that’s “wrong” with you—the cause remains unknown.

What can you do? Managing chronic health conditions, evaluating currently prescribed medications and treating infections are important first steps. Making some simple lifestyle changes, such as avoiding foods or drinks that may irritate the bladder (especially those that contain caffeine and artificial sweeteners) can help. So can Kegel exercises to tone your bladder muscle. Medical interventions include prescription drugs that may help stop the bladder from contracting when it’s not full. Injections of Botox may help some people, as can nerve stimulation treatment, the delivery of electrical pulses to nerves that control bladder function. Warning: A commonly prescribed class of OAB drugs called antimuscarinics can increase the risk of cognitive decline, even dementia, in older people.

Note: Some people have the opposite problem, called underactive bladder. Too little urine may dribble out, and sometimes, since urine can build up in the bladder, there can be incontinence as well. That’s our next topic.

Urinary incontinence

What is it? Urinary incontinence (UI) is leaking urine, either in small or more significant amounts. It’s a common problem as people get older—statistics are hard to come by because many people are too embarrassed to admit the problem, but it’s estimated to affect as many as a quarter to a third of the population. Like OAB, it’s more common in women than men. There are several types:

  • If you leak urine when you laugh, cough, sneeze or exercise, you’ve got stress incontinence.
  • If you can’t get to the bathroom fast enough and you leak urine, that’s urge incontinence. This often happens in people with OAB.
  • If you have both stress and urge incontinence, it’s called mixed incontinence.
  • If you have a medical condition such as a neurological disease or dementia that affects bladder control, it’s called functional incontinence.
  • If you leak urine after you pee, that’s post-micturition dribble (see below), another form of incontinence.

Who gets it? The incidence of UI increases with age in both women and men. For women, pregnancy and childbirth increase your risk because bearing and giving birth weakens the pelvic floor muscles…and risk increases for all women post-menopause. Men with prostate problems may experience UI as well.  The condition is also linked to diabetes, high blood pressure, obesity and smoking. UTIs and other bladder infections can be triggers as well.

What can you do? See a doctor to be sure your incontinence is not the symptom of a urinary tract or bladder infection. Then, you can try exercises to strengthen the pelvic floor or such techniques as bladder training (trying to gradually lengthen the time between bathroom visits) or double-voiding—you urinate, wait a few seconds and then try to go again to be sure you completely empty your bladder.

Post-Micturition Dribble

Now that you’ve got the basics, it should be clear what this condition is—a kind of urinary incontinence that happens after you urinate. A little extra leaks out after you’re done, leaving a spot on your clothing. More frequently seen in men, post-micturition dribble is annoying, potentially embarrassing…but not at all dangerous. Usually, it’s linked to issues like weakened muscles or quirks in the anatomy that let a little bit of urine “pool” before being fully expelled. The best fix is generally muscle-toning moves like Kegel exercises. To learn more, head on back to the Bottom Line article, “Do You Pee in Your Pants After You Pee? There’s a Cure for That.”