Delayed urination; Hesitancy; Difficulty initiating urination
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 provider if you notice urinary hesitancy, dribbling, or a weak urine stream.
Call your provider right away if:
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 urinalysis. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: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.BACK TO TOP
Review Date: 7/31/2019
Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 09/30/2021.
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