Having difficulties with the flow of your urine is called urinary hesitancy or delayed urination. If you have this condition, you may have trouble beginning to urinate or with maintaining the flow. It can occur in anyone at any age, but is most common in older men. In some cases, it may lead to urinary retention, which means being unable to urinate. This can be very serious.
An enlarged prostate causes most cases of urinary hesitancy in older men. It can also be the result of certain medications, infection, surgery, or a nervous system disorder.
There are some home treatments to help relieve hesitancy, but you should talk to your doctor if you experience symptoms. Through an examination, your doctor can pinpoint the underlying cause of your condition and offer treatment options.
There are many possible causes of urinary hesitancy. In men, the condition is usually related to the prostate, but it may also result from disorders of the nervous system, surgeries, infections, or even psychological issues in both women and men.
Most men develop an enlarged prostate as they get older. The swelling puts pressure on the urethra—the tube that carries urine from the body. This pressure makes it more difficult to get a flow of urine started or maintain it.
An infection of the prostate is called prostatitis. It is fairly common in men and can cause swelling that puts pressure on the urethra. In women, urinary tract infections can also lead to difficulty with urination.
Certain medications can cause urination problems in people of any age or sex. The drugs that may cause this side effect include certain cold medications, nasal decongestants, and allergy medications. Anticholinergics—which treat stomach cramps, muscle spasms, and incontinence—and some antidepressants may also cause urinary hesitancy.
Nervous System Disorders and Damage
Damaged or diseased nerves can interfere with your flow of urine. Nerves can be damaged by accidents, strokes, childbirth, diabetes, or brain/spinal cord infections. People with multiple sclerosis and children born with a nervous system disorder may also suffer from nerve damage that causes urination problems.
Anesthesia administered during surgery may impair some of your nerves, resulting in urinary difficulties afterward. Surgery near the bladder, kidneys, or urethra can create scar tissue that constricts the urethra, also causing hesitancy.
Shy Bladder Syndrome
In rare cases, someone with urinary hesitancy may have a psychological problem. The inability to urinate in front of others may prevent these people from getting a flow started or maintaining it in certain situations.
Heat may help to treat your urination problems. Place a hot water bottle or similar device on your lower abdomen between the bellybutton and the pubic bone. The heat relaxes your muscles and can improve flow. You can also massage the area gently to increase flow. It’s also important to drink plenty of fluids.
If hesitancy when urinating is a recurring problem, you should schedule a visit with your doctor. With an exam and diagnostic tools, your doctor can determine the cause of your condition and treat it to help relieve your symptoms.
You should also get emergency help right away if you cannot urinate at all. This is called urinary retention and causes pain and bloating. It can be very serious if not treated.
When you see your doctor for difficulty with urination, you will first have a physical examination. Your doctor will also ask you several questions. He or she will want to know how long you have been experiencing the hesitancy, when it is the worst, if it is gradual or sudden, if your urine flow is weak, if anything helps and if anything makes it worse. You may also be asked about other symptoms you have, your medical history, and any medications or supplements that you are currently taking.
After an examination, your doctor may order tests to determine the reason for your hesitancy. Tests could include analysis of a sample of your urine or a swab from the interior of your urethra. You may also need to have a catheter—a small, flexible tube— inserted into your urethra to get a sample of urine directly from the bladder.
A cystometric study may also be performed. This involves using a catheter to measure the pressure in your bladder and to detect any leakage. For men, a doctor will likely want to create an image of the prostate using an ultrasound. This is a technique that uses sound waves to produce an image of the gland.
If urination difficulties are ignored, the symptoms will only get worse. Urination may become difficult to the point of being impossible and may lead to significant pain. Ultimately, you could end up with urinary retention, which can be an emergency situation. It is best to visit your doctor as soon as you experience symptoms.