Quality statement 5: Conservative management – urethral milking

Quality statement

Men with lower urinary tract symptoms (LUTS) who have post-micturition dribble are given information about how to perform urethral milking.

Rationale

Urethral milking is a technique that when performed correctly reduces urine loss and can usually be learnt in 1 session by men with LUTS who have post-micturition dribble. Men with LUTS who have post-micturition dribble should be shown urethral milking by a healthcare professional and this demonstration should be reinforced by written information.

Quality measures

Structure

Evidence of local arrangements to ensure that men with LUTS who have post-micturition dribble are given information about how to perform urethral milking.

Data source: Local data collection.

Process

Proportion of men with LUTS and post-micturition dribble who are given information about how to perform urethral milking.

Numerator – the number of men in the denominator who are given information about how to perform urethral milking.

Denominator – the number of men with LUTS who have post-micturition dribble.

Data source: Local data collection.

Outcome

Men with LUTS and post-micturition dribble feel informed about how to perform urethral milking to help them to manage their condition.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers ensure that local arrangements are in place for men with LUTS who have post-micturition dribble to be given information about how to perform urethral milking.

Healthcare professionals ensure that men with LUTS who have post-micturition dribble are given information about how to perform urethral milking.

Commissioners ensure that they commission services with local arrangements to give men with LUTS who have post-micturition dribble information about how to perform urethral milking.

What the quality statement means for patients, service users and carers

Men with LUTS who have post-micturition dribble (leakage of urine after urination) are given information about how to empty the urethra (urethral milking) and stop urine leakage.

Source guidance

  • Lower urinary tract symptoms (NICE clinical guideline 97), recommendation 1.3.1.

Definitions of terms used in this quality statement

Post-micturition dribble

Post-micturition dribble describes the involuntary loss of urine immediately after passing urine, usually in the first few minutes after leaving the toilet.

Urethral milking

Urethral milking is also known as post-void milking, bulbar urethral elevation or bulbar urethral massage. Urethral milking eliminates post-micturition dribble caused by incomplete emptying of the urethra by the surrounding muscles rather than by obstruction.

Information on urethral milking

Information on urethral milking may be presented in a combination of formats including leaflet form, in picture format and through demonstration (including online materials).

Equality and diversity considerations

All information on urethral milking should be accessible to men with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Men receiving information should have access to an interpreter or advocate if needed.

Men should be provided with information that reflects any religious, ethnic, transgender or cultural needs.