Urination - difficulty with flow Health Article

Definition

Difficulty starting or maintaining a urinary stream is called urinary hesitancy.

Alternative Names

Delayed urination; Hesitancy; Difficulty initiating urination

Considerations

This problem affects people of all ages and occurs in both sexes, but it is most common in older men with enlarged prostate glands.

Urinary hesitancy usually comes on gradually. It sometimes goes unnoticed until urinary retention (complete inability to urinate) produces distention and discomfort in the bladder.

Almost all older men have some degree of difficulty in starting urination, dribbling, or decreased force of the urinary stream.

Common Causes

Urinary hesitancy can be caused by:

• Benign prostatic hyperplasia (enlarged prostate)
• Urinary tract infection, especially if chronic and recurrent
• Prostatitis (inflammation or infection of the prostate gland)
• Drugs (some cold remedies, some nasal decongestants, tricyclic antidepressants, and anticholinergics which may be used for incontinence)
• Shy or bashful bladder syndrome (unable to urinate when another person is in the room)
• Neurologic disorders

Home Care

• Monitor, record, and report your urination patterns to your doctor.
• Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder lies. The heat relaxes muscles and aids urination.
• Massage or place light pressure over your bladder to stimulate emptying.
• Drink plenty of fluid, especially fruit juices like cranberry.
• For infections, antibiotics from your doctor will be needed. Symptoms that suggest a possible infection include burning or pain with urination, frequent urination, cloudy urine, and a sense of urgency (strong, sudden urge to urinate.)

Call your health care provider if

If you have not been evaluated for this problem previously, you should call your doctor for urinary hesitancy, dribbling, or weak urine stream.

Call your doctor right away if you have fever, vomiting, side or back pain, shaking chills, or passing little urine for 1-2 days.

Call if you have blood in your urine, cloudy urine, frequent or urgent need to urinate, or a discharge from the penis or vagina.