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Urination - difficulty with flow

Definition

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

Alternative Names

Delayed urination; Hesitancy; Difficulty initiating urination

Considerations

Urinary hesitancy affects people of all ages and occurs in both sexes. However, it is most common in older men with an enlarged prostate gland.

Urinary hesitancy most often develops slowly over time. You may not notice it until you are unable to urinate (called urinary retention). This causes swelling and discomfort in your bladder.

Causes

The most common cause of urinary hesitancy in older men is an enlarged prostate. Almost all older men have some trouble with dribbling, weak urine stream, and starting urination.

Another common cause is infection of the prostate or urinary tract. Symptoms of a possible infection include:

The problem can also be caused by:

Home Care

Steps you can take to care for yourself include:

When to Contact a Medical Professional

Call your doctor if you notice urinary hesitancy, dribbling, or a weak urine stream.

Call your doctor right away if:

What to Expect at Your Office Visit

Your doctor will take your medical history and do an exam to look at your pelvis, rectum, abdomen, and lower back.

Your doctor may ask questions such as:

Tests that may be performed include:

Treatment for urinary hesitancy depends on the cause, and may include:

References

Gerber GS, Brendler CB. Evaluation of the urologic patient: In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 3.

Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 116.

Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 125.


Review Date: 12/27/2013
Reviewed By: Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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