Urination - difficulty with flow
Difficulty starting or maintaining a urine stream is called urinary hesitancy.
Delayed urination; Hesitancy; Difficulty initiating urination
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:
When to Contact a Medical Professional
Call your provider if you notice urinary hesitancy, dribbling, or a weak urine stream.
Call your provider right away if:
What to Expect at Your Office Visit
Your provider will take your medical history and do an exam to look at your pelvis, genitals, rectum, abdomen, and lower back.
You may be asked questions such as:
Tests that may be performed include:
Treatment for urinary hesitancy depends on the cause, and may include:
Gerber GS, Brendler CB. Evaluation of the urologic patient: history, physical examination, and the urinalysis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 3.
Landry DW, Bazari H. Approach to the patient with renal disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 114.
Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 125.
Review Date: 8/31/2015
Reviewed By: Jennifer Sobol, DO, urologist at the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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