Difficulty starting or maintaining a urine stream is called urinary hesitancy.
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 usually comes on slowly over time. You may not notice it until you are unable to urinate (urinary retention), and your bladder swells and becomes uncomfortable.
Almost all older men have some trouble with:
Urinary hesitancy can be caused by:
Call your doctor for urinary hesitancy, dribbling, or a weak urine stream if you have not already been evaluated for these problems.
Call your doctor right away if:
Your doctor will take your medical history and perform a physical examination, paying special attention to your pelvis, rectum, abdomen, and lower back.
Medical history questions may include:
Tests that may be performed include:
Treatment for urinary hesitancy depends on the cause. Often, medications such as alpha-blockers can relieve the symptoms. If you have a bacterial infection, your health care provider may prescribe antibiotics. You may need surgery to relieve a prostate obstruction (see TURP).
Delayed urination; Hesitancy; Difficulty initiating urination
Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: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.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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