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 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.
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:
Steps you can take to care for yourself include:
Call your doctor if you notice urinary hesitancy, dribbling, or a weak urine stream.
Call your doctor right away if:
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:
Delayed urination; Hesitancy; Difficulty initiating urination
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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: 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.
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