BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuUrination - difficulty with flowDelayed urination; Hesitancy; Difficulty initiating urinationDifficulty starting or maintaining a urine stream is called urinary hesitancy. 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.Enlarged prostateThe prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...ImageRead Article Now Book Mark Article 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:Burning or pain with urination Frequent urination Cloudy urine Sense of urgency (strong, sudden urge to urinate) Blood in the urineThe problem can also be caused by:Some medicines (such as remedies for colds and allergies, tricyclic antidepressants, some medicines used for incontinence, and some vitamins and supplements) Nervous system disorders or problems with the spinal cord Side effects of surgery Scar tissue (stricture) in the tube leading from the bladder (urethra) Spastic muscles in the pelvis Home Care Steps you can take to care for yourself include:Keep track of your urination patterns and bring the report to your health care provider. Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder sits. The heat relaxes muscles and aids urination. Massage or apply light pressure over your bladder to help the bladder empty. Take a warm bath or shower to help stimulate urination. 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:You have a fever, vomiting, side or back pain, shaking chills, or are passing little urine for 1 to 2 days. FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article VomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article You have blood in your urine, cloudy urine, a frequent or urgent need to urinate, or a discharge from the penis or vagina. You are unable to pass urine. 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:How long have you had the problem and when did it start? Is it worse in the morning or at night? Has the force of your urine flow decreased? Do you have dribbling or leaking urine? Does anything help or make the problem worse? Do you have symptoms of an infection? Have you had other medical conditions or surgeries that could affect your urine flow? What medicines do you take? Tests that may be performed include:Blood urea nitrogen test Creatinine (serum) Electrolytes (serum) Catheterization of the bladder to determine how much urine remains in your bladder after trying to urinate and to get urine for culture (a catheterized urine specimen) Cystometrogram or urodynamic study CystometrogramA cystometric study measures the amount of fluid in the bladder when you first feel the need to urinate, when you are able to sense fullness, and whe...ImageRead Article Now Book Mark Article Transrectal ultrasound of the prostate UltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article Urethral swab for culture Urinalysis and culture UrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article Voiding cystourethrogram Voiding cystourethrogramA voiding cystourethrogram is an x-ray study of the bladder and urethra. It is done while the bladder is emptying.ImageRead Article Now Book Mark Article A bladder scan and ultrasound (measures urine left behind without catheterization) CystoscopyCystoscopyCystoscopy is a surgical procedure. This is done to see the inside of the bladder and urethra using a thin, lighted tube.ImageRead Article Now Book Mark Article Treatment for urinary hesitancy depends on the cause, and may include: Medicines to relieve the symptoms of an enlarged prostate. Antibiotics to treat any infection. Be sure to take all your medicines as directed. Surgery to relieve a prostate blockage (transurethral resection of the prostate, TURP). TURPTransurethral resection of the prostate (TURP) is a surgery to remove the inside part of the prostate gland. It is done in order to treat symptoms o...ImageRead Article Now Book Mark Article Procedure to dilate or cut scar tissue in the urethra.Open ReferencesReferencesElsamra SE. Evaluation of the urologic patient: history and physical examination. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 1.Smith PP, Kuchel GA. Aging of the urinary tract. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 22.AllVideoImagesTogFemale urinary tract - illustration The female and male urinary tracts are relatively the same except for the length of the urethra.Female urinary tractillustrationMale urinary tract - illustration The male and female urinary tracts are relatively the same except for the length of the urethra.Male urinary tractillustrationFemale urinary tract - illustration The female and male urinary tracts are relatively the same except for the length of the urethra.Female urinary tractillustrationMale urinary tract - illustration The male and female urinary tracts are relatively the same except for the length of the urethra.Male urinary tractillustrationRelated Information Review Date: 7/1/2023 Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, 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. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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Urination - difficulty with flowDelayed urination; Hesitancy; Difficulty initiating urinationDifficulty starting or maintaining a urine stream is called urinary hesitancy. 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.Enlarged prostateThe prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...ImageRead Article Now Book Mark Article 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:Burning or pain with urination Frequent urination Cloudy urine Sense of urgency (strong, sudden urge to urinate) Blood in the urineThe problem can also be caused by:Some medicines (such as remedies for colds and allergies, tricyclic antidepressants, some medicines used for incontinence, and some vitamins and supplements) Nervous system disorders or problems with the spinal cord Side effects of surgery Scar tissue (stricture) in the tube leading from the bladder (urethra) Spastic muscles in the pelvis Home Care Steps you can take to care for yourself include:Keep track of your urination patterns and bring the report to your health care provider. Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder sits. The heat relaxes muscles and aids urination. Massage or apply light pressure over your bladder to help the bladder empty. Take a warm bath or shower to help stimulate urination. 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:You have a fever, vomiting, side or back pain, shaking chills, or are passing little urine for 1 to 2 days. FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article VomitingNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...ImageRead Article Now Book Mark Article You have blood in your urine, cloudy urine, a frequent or urgent need to urinate, or a discharge from the penis or vagina. You are unable to pass urine. 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:How long have you had the problem and when did it start? Is it worse in the morning or at night? Has the force of your urine flow decreased? Do you have dribbling or leaking urine? Does anything help or make the problem worse? Do you have symptoms of an infection? Have you had other medical conditions or surgeries that could affect your urine flow? What medicines do you take? Tests that may be performed include:Blood urea nitrogen test Creatinine (serum) Electrolytes (serum) Catheterization of the bladder to determine how much urine remains in your bladder after trying to urinate and to get urine for culture (a catheterized urine specimen) Cystometrogram or urodynamic study CystometrogramA cystometric study measures the amount of fluid in the bladder when you first feel the need to urinate, when you are able to sense fullness, and whe...ImageRead Article Now Book Mark Article Transrectal ultrasound of the prostate UltrasoundUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article Urethral swab for culture Urinalysis and culture UrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article Voiding cystourethrogram Voiding cystourethrogramA voiding cystourethrogram is an x-ray study of the bladder and urethra. It is done while the bladder is emptying.ImageRead Article Now Book Mark Article A bladder scan and ultrasound (measures urine left behind without catheterization) CystoscopyCystoscopyCystoscopy is a surgical procedure. This is done to see the inside of the bladder and urethra using a thin, lighted tube.ImageRead Article Now Book Mark Article Treatment for urinary hesitancy depends on the cause, and may include: Medicines to relieve the symptoms of an enlarged prostate. Antibiotics to treat any infection. Be sure to take all your medicines as directed. Surgery to relieve a prostate blockage (transurethral resection of the prostate, TURP). TURPTransurethral resection of the prostate (TURP) is a surgery to remove the inside part of the prostate gland. It is done in order to treat symptoms o...ImageRead Article Now Book Mark Article Procedure to dilate or cut scar tissue in the urethra.Open ReferencesReferencesElsamra SE. Evaluation of the urologic patient: history and physical examination. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 1.Smith PP, Kuchel GA. Aging of the urinary tract. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 22.